
Qass 

Book 



COPYRIGHT DEPOSIT 




JOHN A . M I L L E R , M , D 



FEMINA, 



A WORK FOR EVERY WOMAN 

ILLUSTRATED. 



A perfect woman, nobly plann'd, 
To warn, to comfort and command; 
And yet a spirit still, and bright, 
With something of an angel light. 

— Wordsworth. 



JOHN A. MILLER, M. D. 

Graduate Medical Department University of California, also holding 
Credentials from the Universities of Berlin and 

Heidelberg, Germany. ' 



SAN FRANCISCO, 

THE FEMINA COMPANY, 

1893. 



V\ 



fo* 



Entered According to Act of Congress, in the Year 1893 
BY JOHN A. MIDLER, 
In the Office of the Librarian of Congress, 
at Washington, D. C. 



/ 




TO 



11 



THE LATE 

DR. CARL SCHROEDER, 

PROFESSOR OF DISEASES OF WOMEN 

IN THE FREDERICK WILLIAM UNIVERSITY, BERLIN: 

MY TEACHER AND FRIEND. 



cfo 



PREFATORY NOTE. 



The publication of this volume was suggested by the astonishing ig- 
norance displayed and the antiquated ideas entertained upon questions 
of health and disease by most persons with whom I came in professional 
contact, even by those who were accomplished in other subjects of a 
scholastic and scientific nature. The practical importance of the subject 
naturally led me to the consideration of diseases that are essentially in- 
flammatory, for over seventy-five per cent of all diseases of women are of 
an inflammatory nature. In this respect the book differs from other 
works on similar subjects. 

In discussing this class of diseases I have aimed to present a treatise 
simple in style, and easily understood by the casual reader. While I 
have endeavored to impart strictly scientific information, I have tried to 
impart it in familiar language, avoiding the use of technical terms as far 
as possible, and carefully defining them when their use became indis- 
pensable. 

JOHN A. MILLER, M. D. 

No. 1137 Geary Street, San Francisco, Cal. 



@^,j£^) 



BY THE SAME AUTHOR. 



MEDICAL EDUCATION IN THE UNITED STATES AND AN OUT- 
LINE OF THE GERMAN SYSTEM. Essay read before the 
Alumni Association of the Medical Department of the University 
of California, March, 1886. 

EROSIONS OF THE VAGINAL PORTION OF THE CERVIX, OR 
ULCERATION OF THE SAME PART. Pacific Medical and Sur- 
gical Journal, January, 1887. 

RETROVERSIO-FLEXIO AND A NEW INSTRUMENT FOR THE 
REPOSITION OF THE UTERUS. American Journal of Obstetrics 
and Diseases of Women and Children, February, 1887. 

UTERINE HEMORRHAGE AND LIGATION OF THE UTERINE 
VESSELS AS A THERAPEUTIC EXPEDIENT. The New York 
Medical Record, September, 1889. 

PHLEGMASIA ALBA DOLENS, OR MILK LEG; ITS PATHOLOGY 
AND TREATMENT BY MEANS OF COLD WATER COMPRESSES 
AND ICE BAGS. Pacific Medical Journal, June, 1891. 



<^7$P^> 



CONTENTS, 

CHAPTER I. 
THE REASON WHY 15 

CHAPTER II. 

DELUSIONS AS TO THE CURATIVE VALUE OF DRUGS 36 

CHAPTER III. 

WHAT IS MIND CURE? 46 



CHAPTER IV. 

GENERAL CAUSES OF UTERINE AND PELVIC DISEASES OF 
WOMEN 61 



CHAPTER V. 

UNCLEANLINESS AS A CAUSE OF DISEASES IN WOMEN 76 

CHAPTER VI. 

MARITAL EXCESSES AND PREVENTION OF CONCEPTION... 87 

CHAPTER VII. 
CRIMINAL ABORTION OR FETICIDE......... 101 



CONTENTS. 

CHAPTER VIII. 
ANATOMY OF THE FEMALE ORGANS ..119 

CHAPTER IX. 
MENSTRUATION AND MENSTRUAL DISORDERS 126 

CHAPTER X. 

HISTOLOGY OF INFLAMMATION 145 

CHAPTER XL 
URETHRITIS AND NEURALGIA OF THE URETHRA 150 

CHAPTER XII. 

INFLAMMATION, CATARRH, AND OTHER DISORDERS OF 
THE BLADDER , 157 

CHAPTER XIII. 
ACUTE AND CHRONIC INFLAMMATION OF THE VAGINA....172 

CHAPTER XIV. 

HYGIENIC MEASURES FOR CATARRHAL DISEASES OF THE 
FEMALE ORGANS 182 

CHAPTER XV. 

METRITIS OR INFLAMMATION OF THE WOMB 196 

CHAPTER XVI. 

CHRONIC METRITIS OR CHRONIC INFLAMMATION OF THE 
WOMB ". 203 



CONTENTS. 

CHAPTER XVII. 

ENDOMETRITIS OR CATARRHAL INFLAMMATION OF THE 
WOMB 209 

CHAPTER XVIII. 

THE NATURAL POSITION OF THE UTERUS AND HOW IT 
IS SUPPORTED 226 

CHAPTER XIX. 
PROLAPSUS OR FALLING OF THE WOMB 231 

CHAPTER XX. 
VERSIONS AND FLEXIONS OF THE WOMB 240 

CHAPTER XXI. 

DISEASES OF THE FALLOPIAN TUBES... 258 

CHAPTER XXII. 

DISEASES OF THE OVARIES 263 

CHAPTER XXIII. 

PERIMETRITIS AND PELVIC PERITONITIS.... 275 

CHAPTER XXIV. 
PELVIC CELLULITIS OR PARAMETRITIS ...285 

CHAPTER XXV. 
ELECTRICITY AS A REMEDY 294 



CONTENTS. 

CHAPTER XXVI. 
SIGNS AND SYMPTOMS OF PREGNANCY 305 

CHAPTER XXVII. 

PRECAUTIONS AND SUGGESTIONS TO PREGNANT 

WOMEN 315 

CHAPTER XXVIII. 

WHILE IN CHILD BED , 328 

CHAPTER XXIX. 
DISEASES PECULIAR TO CHILDREN 341 

CHAPTER XXX. 
DISEASES PECULIAR TO CHILDREN— Continued 356 

CHAPTER XXXI. 
EMERGENCY TREATMENT IN SUDDEN ACCIDENTS 377 

CHAPTER XXXII. 

SOMETHING ABOUT DIET 392 



CHAPTER I. 

THE REASON WHY. 

I see a large field of usefulness which has not been cov- 
ered by competent authorities. I propose, therefore, to offer 
a plain, simple statement of the most common causes of 
physical suffering in women, and a simple and reliable 
method of home or domestic treatment, to be carried out 
by the patients themselves, which, in the great majority of 
cases, is easily applied. 

The first nine years of my professional life was an untir- 
ing and incessant devotion to the arduous demands of a 
large family practice, after which I decided to go to Europe, 
and there prosecute such studies in two German universities 
as my experience as a practitioner had fully convinced 
me to be of the greatest practical and scientific importance; 
hence, I offer no excuse or apology for aught I may say on 
a subject with which I have taken especial pains to famil- 
iarize myself. Having in a measure established my iden- 
tity, I am more fully prepared to proceed in a more con- 
genial way. 

In the realm of thought there is no monopoly, and it is, 
after all, at the bar of public opinion that a final judgment 
must decide the merits of my course. 

The question is not what to teach, but whom to teach. 
This may seem, at first sight, an easy matter to determine, 
but a more careful inquiry will show the complexity. 

The platform of a medical college is considered by some 
the only legitimate place from which a medical man may 
impart his knowledge, but here the opportunity is lim- 
ited, notwithstanding the abnormally great number of these 
institutions. This, however, is not the only reason. Med- 
ical colleges are becoming so numerous, that they should 

(15) 



16 HOME TREATMENT. 

be discouraged by all honest and high-minded medical 
men*, because in this country they are private institutions, 
with very few exceptions, and subserve sinister purposes, in 
furthering the interests of their promoters either as adver- 
tising schemes or money-making institutions, or both. 

Of course they are incorporated under State laws, which 
make them quasi-public institutions, but the State exercises 
no authority over them, and their self-constituted professors 
conduct them to suit their own private ends. They are 
not limited by law, nor is a required course for their stu- 
dents imperative, so that the public have no guarantee of 
the fitness or competency of their graduates. There is, also, 
an unhealthy rivalry among our colleges for students, im- 
proper material is taken in, and correspondingly poor 
material is turned out ; this in turn causes a rivalry among 
their graduates in making spoil of the sick. 

Every self-respecting and competent medical man has 
an utter contempt for these doctor mills. This will never 
be different in this country until we follow the plan of 
European governments, and make medical colleges State 
institutions, and their professors officers of the State, with 
liberal salaries. 

The medical press has a comparatively limited oppor- 
tunity for imparting information to the public, unless the 
editor of the secular press happens to make a quotation. 

The exclusiveness that has characterized the learned 
professions generally, and the medical profession particu- 
larly, is rapidly passing away. Only half a century ago, the 
medical lectures in Germany were mostly delivered in the 
Latin language, and, while we now often suffer, in listening 
to medical lectures in bad English, the latter may still be 
the lesser evil. In fact, so great is the deference to public 
opinion in favor of diffusing knowledge that medical fac- 
ulties court popular favor by delivering a course of lectures 
on medical subjects, and consider these the best-drawing 
card of the institution. 



THE REASON WHY. 17 

Information that is not sensational nor untruthful can- 
not fail to do incalculable good to the class for whom it is 
intended, namely, our wives, mothers, daughters, and sisters, 
so that they may avoid errors, that entail suffering and dis- 
ease; information that will teach them how to cure them- 
selves of the commoner and simpler ailments, and thus 
avoid running to the doctor, who cannot always afford to 
tell them the truth. Some would not if they could. 

The Darwinian theory is of wider application than to 
mere animal or plant life; it extends itself to the over- 
crowded professions, and the increasing "struggle for ex- 
istence" in the ranks of the profession makes men dishonest 
and greedy for any opportunity to raise a fee, so that patients 
are being treated for diseases which are created for them 
by the cunning and dishonesty of their doctors. 

A little common sense and a knowledge of the elemen- 
tary principles of disease would be the best protection against 
these deceptions; but, as a rule, sick persons are inclined to 
throw aside all good sense, and give themselves up entirely 
to their feelings or to their doctor. This is a very wrong 
thing to do, and opens the door for all manner of imposi- 
tions. 

The general practitioner of thoughtful and studious 
habits finds that, in the course of years, a diversified read- 
ing on the different diseases which in the routine of his 
w T ork he is called upon to treat makes him a generally well- 
informed man, but not a thoroughly exact man, either in 
theory or in the details of his treatment. 

Fifty to sixty years ago the entire field of medicine was 
comparatively so small that it was easier for a brilliant 
mind then, to comprehend all that was believed to be known, 
than it is for the same quality of mind to understand any 
of the subdivisions of medicine to-day. 

Those were the days of doctrines and rules. Little that 
was absolutely correct or true was then known about disease, 
otherwise such absurd theories as the " dynamization or 
spirit-like" influence, causing disease on the one hand, or 

Li 



18 HOME TREATMENT. 

that the " great source " of chronic diseases was psora, or 
itch, on the other, as Hahnemann would have them believe, 
could never have gotten a foothold. 

These are the days of scientific deductions from micro- 
scopical and physiological research, in laboratories con- 
nected with great universities, and the result is, that any of 
the specialties or subdivisions of medicine is as large and 
interesting a field as the entire area was some time ago. 
It thus happens, that some thoughtful persons, after years 
of general practice, drift almost involuntarily into some 
one department of medical art and science. To this they 
become gradually wedded, and in it they grow in knowl- 
edge and experience far beyond their previous anticipations. 
What they read on the subject is better understood, and new 
ideas are constantly formed, which enlarge the scope of their 
knowledge. In this manner the writer drifted into the 
domain of diseases peculiar to women, which was as un- 
happy on the one hand, as it is interesting on the other, for 
the phrase "diseases of women" has fallen into disrepute 
because every superficial, practitioner professes to know all 
about them, and it often is but another name for criminal 
abortion. 

But for all that, there is a legitimate and scientific spe- 
cialty of women's diseases. The time-serving specialist must 
be exposed in every department of medical science. Whether 
the pretender is labeled, a professor in a college, or labels 
himself through glaring newspaper advertisements, one is 
just as much a catch-penny as the other. 

The object of educating the laity cannot be reasonably 
confined to a few medical truths, but the perversion of the 
truth must also be understood, so that the false can be de- 
tected. It is necessary to point out the dangers and frauds 
which are the unhealthy outgrowths or excrescences of 
established truths, and there must be no veneering of the 
wicked and sinful with ambiguous phrases to shield the 
guilty; the truthful and innocent require no apologist. 

The honest observer can pursue no middle way in a 



THE REASON WHY. 19 

work to which he has devoted the best years of a studious 
life,- and hence he may seem radical in his opinions. While 
policy often dictates a conservative course, that which con- 
science and reason dictate to be true is prompted by loftier 
motives, namely, to subserve the highest purpose of moral 
integrity. 

It has often been said that this is a mechanical age. 
How true is this even in the furtherance of science ! How 
true is this of the science of astronomy, which was revolu- 
tionized by the construction of good telescopes! Mechanical 
genius has perfected a lens for Mount Hamilton thirty-six 
inches in diameter, and one is now in course of construction 
for Mount Wilson, in Southern California, which is to 
measure forty inches. Through these means scientists hope 
to decipher the complexion of remote planets. 

Microscopic lenses have been equally perfected, and, by 
means of achromatic condensers and immersion lenses, 
great magnifying power can be obtained with perfect dis- 
tinctness. That this mechanical spirit of the age should 
also have obtained a foothold in medical art and science, 
is but natural. Surgical and other mechanical methods 
have entered so boldly into the field of diseases of women 
that the writer feels constrained to sound a note of alarm. 
Great strides have been made in a more perfected technique 
in abdominal operations, and, by favorable recoveries from 
grave and severe operations, the field of surgical usefulness 
became enlarged, but this has degenerated into a license 
for notoriety and personal aggrandizement of not over- 
scrupulous and selfish surgeons who are over-anxious to 
■operate so as to be able to boast of the great number of 
their capital operations, or laparotomies. 

I was enthusiastic in abdominal and pelvic surgery, but 
not until I entered the field as a specialist in this depart- 
ment of medicine did I see and hear of daily abuses and 
misuses of this branch of surgery. In many instances it 
■degenerated into criminal malpractice. It will be instruct- 



20 HOME TREATMENT. 

ive information to cite a few cases which occurred under 
my observation, and present the actual facts to the reader. 

It was in the month of February, in the year 1888, that 
a business trip to the southern part of the State forced an 
absence of several weeks upon me. Some two months before 
this time I had been called to see a young woman, who had 
then been sick for several months. She informed me that 
she had been married nine years, and, not having had any- 
children, she concluded to see a noted specialist of female- 
diseases. By this physician she was told that her sterility 
was owing to a closure or contraction of the mouth of the 
womb. This was obviously a wrong diagnosis, and for 
these reasons: she had always menstruated regularly and 
without pain, which excludes a constriction ; and, secondly,, 
no physician can honestly call a woman sterile until h& 
has examined her husband, who, in the majority of in- 
stances, is the cause of his wife's sterility, because it is he- 
who is sterile. This woman and the doctor agreed, how- 
ever, on a course of treatment, which was to forcibly open, 
or stretch the mouth and cervical canal of the womb. This- 
by itself is neither a dangerous nor a severe operation, if 
carefully performed, but care in this case was evidently not 
exercised, because the young woman was taken with severe 
inflammation, which caused a pelvic abscess. 

I found her after two months of suffering. The dis- 
charge had become extremely offensive, her body emaciated, 
and her strength exhausted. 

I enlarged the opening of the abscess, placed a large- 
drainage tube in the cavity, through which it was washed out,, 
by means of an antiseptic solution of bichloride of mercnry, 
1 part to 2,000 parts of water, and, by further giving her 
simple, nutritious food, she improved rapidly, so that the 
day before I left the city she was at my office, and told mo 
that she felt as well as ever, although not thorough^ re- 
covered. I was absent two weeks, and a few days after nry 
return I incidentally met her husband, who told me that 






THE REASON WHY. 21 

sl week after I had left, his wife felt unwell and called in 
one of her former doctors, who, by the way, rides a hobby- 
horse on surgery. This man found a few pimples on her 
body, which can be found on almost any healthy person, 
these, he said, were signs of blood poisoning from her ab- 
scess, and that an operation to extirpate the abscess, with 
one or both of her ovaries, was of urgent necessity to save 
her life from blood poisoning. The deceived woman was 
of course frightened into giving her consent to the opera- 
tion, which was undertaken immediately, and, as luck would 
have it, she recovered; but she might have easily died, 
which she undoubtedly would have done had this knife- 
man got her sooner, or before I had restored to her a splendid 
physical condition, which withstood the unnecessary butch- 
ery to which she was induced to submit. 

Some doctors seem to have a perfect mania for cutting 
operations, just as though the entire science and art of 
medicine were exhausted in surgery alone. To assume this 
for an instant is manifestly ridiculous. More lives are an- 
nually saved by a scientific application of other methods 
of cure than the most elaborate and brilliant statistics of 
surgery can approach. There is science and skill in select- 
ing proper medicines, in the employment of hygiene or the 
Tules of health, in the practice of obstetrics, and in a variety 
of other ways to demonstrate the triumphs of the art of 
healing. 

The rash and unnecessary resort to the knife has brought 
surgery into general distrust, so that some patients would 
rather die, or wait until they are almost dead, before they 
allow an operation to be performed on them, in cases where 
surgery is, indeed, the only possible method of cure. 

A lady recently called at my office for a consultation. 
I found her uterus and other pelvic organs in a perfectly 
healthy condition, although she suffered pain there. This 
was due to neuralgia from a generally exhausted and de- 
bilitated condition. I was not a little surprised to learn, 



22 HOME TREATMENT. 

from her own lips, that she had been treated for womb 
disease, and was about to undergo an operation for a tear hx 
the mouth of her womb. This was manifestly absurd, be- 
cause no laceration existed at all, and if there had it might 
not have been necessary, because it is quite natural for 
women who have borne children to have the scars of old 
lacerations on the mouths of their wombs, and they are not 
any the worse for them. 

It is important for mothers to know something about 
themselves and of the common diseases to which they are- 
liable, for then they will not be so easily persuaded to per- 
mit the use of caustics, or the cutting, stitching, or scraping- 
of their wombs, which is quite likely to excite complicated 
inflammations, more serious in their results than the diseases 
for which these operations were performed. I know of what 
I write, and there is no one who can successfully deny it. 

Dr. William Goodell, who stands as high in the depart- 
ment of diseases of women as any American, had an article 
in one of the medical journals on "The Abuses of Uterine 
Treatment." He says: " From a large experience I humbly 
offer to the reader the following watchwords as broad helps- 
to diagnosis: 1. Always bear in mind what another has- 
pithily said, that ' woman has some organs outside of the 
pelvis.' 2. Each neurotic case will usually have a tale of 
fret or grief, of cark and care, of wear and tear. 3. Scant 
or delayed or suppressed menstruation is far more frequently 
the result of nerve exhaustion than of uterine disease. 4_ 
Anteflexion of the womb, per se, is not a pathological con- 
dition. It is so when associated with sterility or painful 
menstruation, and only then does it need treatment. 5. 
An irritable bladder is more a nerve symptom than a uterine 
one. 6. In a large number of cases of supposed or actual 
uterine disease, which display marked gastric disturbance, if I 
the tongue be clean the essential disease will be found to be 
neurotic, and it must be treated so. 7. Almost every sup- 
posed uterine case, characterized by excess of ■ sensibility" 



THE REASON WHY. 23 

and by lack of will-power, is essentially a neurosis. 8. In 
the vast majority of cases in which the woman takes to her 
bed, and stays there indefinitely, from some supposed uterine 
lesion, she is bedridden from her brain and not from her 
womb. I will go further, and assert that this will be the 
rule even when the womb is displaced, or it is disordered 
by a lesion or disease, that is not in itself exacting or 
dangerous to life. Finally, uterine or womb symptoms are 
not always present in cases of uterine disease, nor, when 
present and even urgent, do they necessarily come from 
uterine disease, for they may be merely nerve counterfeits 
of uterine disease." 

There is not a physician of any extended experience 
in the land who, if he be true to his better judgment, will 
not indorse every word of Professor Goodell's propositions. 
But the chances are they will never accomplish the good 
for which they were intended if the mothers, wives, and 
daughters are not permitted " a little peep " behind the 
curtain, and learn for themselves. For those who are 
wealthy and have plenty of money, doctoring may be a 
luxury or an amusement, but there the line must be drawn 
for the benefit of the deserving poor, with whom any treat- 
ment is a hardship. Stupidity of the masses is one of the 
causes of the abuse of surgical treatments, for they always 
look upon a surgical or bloody operation as one of the 
greatest achievements of modern medical art. Then there 
is the cupidity of the professional classes, who trade upon 
this popular error and delusion, and charge correspond- 
ingly large fees, which, as a rule, are exorbitant, particularly 
when the working classes are the sufferers. 

A little cutting or stitching is much more quickly done, 
and the patient may be dismissed as cured, or left under 
the impression " that everything was done that could have 
been done," than a conservative medical or hygienic treat- 
ment, which involves more thought, labor, and patience, 
qualities which are not as eagerly cultivated as the art 



24 



HOME TREATMENT. 



to wring out a good fee by a little surgery, with less labor 
and skill. 

There is not only too much mischievous doctoring, but 
there is too much of every kind, whether good, bad, or in- 
different. The trouble is there are too many in the ranks 
of the medical profession ; and this is not only true of this 
country, but is raising a cry of warning in Europe. The 
struggle for existence is a natural law, and nature is immu- 
table. I do not mean to say, that it is a humane law, or 
that competition is a virtue; in fact, I believe quite the 
reverse. But much that is natural from a physical stand- 
point might not be so from a moral or spiritual plane ; thus 
the two natures are distinct. 

It is reasonable to suppose that, if the natural crop of 
diseases falls short of supplying the demands of those who 
hunger for an opportunity to treat disease, and it lies 
within their power to create disease, they will certainly 
do so. The deficiency must be supplied, or one of two 
things must be done by the doctor: he must either starve, 
or go to work at something else. This may be cruel logic, 
but I know that these are the actual facts. 

Now let me ask how many persons who have some sort 
of a diploma will be self-sacrificing enough or sufficiently 
unselfish to prefer to starve or honestly work for a living, 
if they can avoid either, by defrauding someone out of a fee , 
for pretending to cure some manufactured disease ? It seems 
almost a waste of time to argue such a self-evident proposi- 
tion. I have known physicians of high standing who treated 
women for womb diseases which never had a real existence, 
and surgeons of large incomes to remove the female breast 
for a "supposed cancer;" and, that being the case, what 
would you expect from a less fortunate brother practitioner 
who is eking out a miserable existence ? 

How many a case of simple sore throat or tonsilitis is 
being paraded as a case of diphtheria. Why, I know of 
doctors who built up their reputations in that way. It is 



THE REASON WHY. 25 

<jiiitc an easy matter, to call an ordinary, simple case of 
bronchitis, pneumonia. Harmless swellings, no matter 
of what sort, are treated and palmed off every day as 
cancers. The quack cancer doctor is almost ubiquitous. 
Some would much rather part with the village parson, or 
their regular old town doctor, than to part with the cancer 
doctor. Diseases that are conjured up in the minds of sus- 
ceptible or hypochondriac persons have for them a real 
existence, because if a person believes he has a certain dis- 
ease, it becomes a reality, as far as his own state of mind 
is concerned, and as far as the treatment is concerned to 
him who created the delusion, it is much more desirable 
than if the disease were real, because you can cure an im- 
aginary disease, which may be impossible when a real one 
comes under treatment. This is another method of making a 
reputation for extraordinary cures that really never occurred. 

When I contemplated writing a book, which I hoped 
to make a vade mecum for those who felt interested in the 
subject, I felt that it would be a duty which I should reluc- 
tantly perform, for it would be a criticism on the status of 
the medical profession of this country. I was convinced 
that whatever I said that would lower the tone of the pro- 
fession in the estimation of my countrymen would naturally 
reflect on me as unfavorably as upon any other member, 
for I never claimed to be anything else but an American 
physician, and, as such, I have an ambition to elevate the 
rank and file to honor and respectability. 

There is also a motive that underlies a work of this 
nature which should appear justifiable to the author. It 
is absolutely necessary that side-lights should be thrown 
into dark corners and recesses that are usually screened from 
public notice. If there is a growing deterioration in meth- 
ods of proficiency and morals, the public should know it, for 
who is the greater villain, he who trifles with human life 
through officious ignorance and venturous operations, or the 
midnight assassin, who, under cover of darkness, waylays 



26 HOME TREATMENT. 

his unwary victim? The title "doctor," from the Latin. 
doceo, " I teach/' has a halo of learning that it derives from 
the original significance that was attached to it when it was 
first sanctioned at Bologna University, about the middle of 
the twelfth century, where it first passed into the faculty of 
divinity. It was afterwards introduced into the universities 
of Northern Europe, and remained ever since a degree of 
distinction in theology, law, philosophy, and medicine. In 
the German universities doctor implies also a license to teach 
within the university, as a privat-docent. 

When we now consider that no person can matriculate 
in a German university who has not graduated from the 
gymnasium or high school, it is clear that, under the above 
conditions, the title " doctor " guarantees that the possessor 
is an educated person, not only of the high school, but added 
thereto is the accomplishment in the specialty of which he 
holds the doctor degree. 

What may a "doctor degree" mean in this country? 
The title of an illiterate and utterly incompetent person, 
who was by natural environment and occupation a teamster, 
saloon keeper, barber, tailor, or patent-medicine vender, etc. 

If a woman, she may be retraced to an ignorant nurse, 
midwife, or quacksalver, the conceited wife of a man who 
indulges her in the freak of " learning to be a doctor," for 
she had demonstrated her genius for the profession by suc- 
cessfully treating a case of measles, which started the doc- 
tor's bee a-buzzing in her bonnet, until she passed through 
a medical college; last, but not least, are the winsome 
daughters of the millionaire or successful business man, 
who imagine themselves too smart to make useful house- 
wives and good mothers. 

There is not a medical college in this State, and there are 
few, if any, in the United States, that would not eagerly 
take in all of this material, and guarantee to them before- 
hand, that they can graduate as medicinsc doctor in twelve 



THE REASON WHY. 27 

months to three years, a five months' course being consid- 
ered a year. 

The above comparison is a disgraceful commentary on 
the degree of doctor in this country, and the public should 
learn to know the difference. 

" The United States and Its Doctors " is the title of an 
editorial in the July number of the New York Medical 
Record, and it says : " There is certainly no more curious 
social phenomenon than that of the extraordinary popu- 
larity of the medical profession in this country as a means 
of securing a livelihood. 

" This subject is one that is often dwelt upon, but we 
doubt if many even yet realize the grotesque misproportion 
which medicine in the United States holds to other bread- 
winning occupations. Here are some of the naked facts in 
the matter : — 

"France has 38,000,000 of population, 11,995 doctors, 
while it graduates 624 medical students in one year. Ger- 
many has 45,000,000 of population, about 30,000 doctors, 
and graduates 935 students in one year. The United States 
has about 60,000,000 of population, 100,000 doctors, 13,- 
091 medical students, and graduates 3,740 students in one 
year. 

" Germany, which has relatively less than half as many 
doctors as America, is already groaning over its surplus. 
When one compares France with this country, the excess of 
medical men here seems most astonishing. 

"A comparison of the United States with Europeon coun- 
tries, in whatever way it is made, leads one to think that 
there is something almost alarming in our medical pro- 
ductiveness." 

In connection with the above comparison, in which it is 
shown that Germany has proportionately less than half as 
many doctors, as the United States, it will be interesting to 
learn the views of the German profession. The Berlin cor- 
respondent of the Medical Press writes that the " Deutcher 



28 HOME TREATMENT. 

iErztebund," Society of German physicians, felt it to be their 
duty to warn the guardians of young men studying in the 
gymnasiums or high schools, against entering the medical 
profession, the state of overcrowding being so great as to 
insure disastrous consequences. In glancing over the above 
figures, there is one very important point which is greatly 
in favor of the German profession and militates against 
the Americans. It is the enormous patent-medicine trade 
and quacking that is done through it in the United States ; 
on the whole, this has been calculated to amount to at least 
fifty per cent of all the doctoring that is done ; that means, 
that where one hundred doctors now practice for a living, 
fifty more could make a similar living, were it not for the 
patent and quack medicine trade, which, in some of the 
German States, is almost prohibited, and in others I know 
it is entirely inhibited. 

When the Society of German physicians warns the Ger- 
man people that an overcrowding " insures disastrous con- 
sequences," what does it mean ? 

This is a question which, we presume, was answered in 
Germany, and it is certainly worth our while that we should 
answer it here, and in this we have decidedly the advantage, 
because in that country the answer was entirely based upon 
what was anticipated, while in this we can answer from what 
we have already realized, namely, disastrous consequences 
to honor and to integrity on the one side, and to health and 
security against imposition on the other. To this I have 
already referred. Everyone competent of judging, and who 
has lived in that country, knows from study and observation 
that the arrangements and conveniences there for treating 
the sick are in a much higher state of perfection than with 
us. Hospitals and physicians are as accessible to all classes 
as the most humane and philanthropic heart can desire, 
and now we learn that if this wholesome state of affairs 
shall continue with less than half the proportion of doctors 
that we have here, there must be no further increase of 



THE REASON WHY. 20 

physicians, or it would insure disaster. This statement and 
warning a close and careful observer clearly appreciates. 
The writer was personally acquainted with a large number 
of German practitioners while in that country, and knows 
as an actual fact that while their fees were and are much 
smaller than anything ever paid in this country, they had 
not overmuch to do, and were only leisurely employed. This 
applies to some of the greatest and world-renowned medical 
professors, as well as to the ordinary general practitioners. 
But there is a reason for all this, too. These men as a rule 
are honest, they are no money grabbers, they are thoroughly 
competent and scientific and manufacture no diseases to 
suit emergencies nor conjure up complaints that have no 
real existence. If their number were doubled, if the normal 
proportion were disturbed, the disaster would surely follow, 
professional demoralization would ensue. So the German 
profession sounds a timely note of warning ere the canker 
of selfishness has destroyed the noble altruistic principles of 
physicians, without which the doctor is as likely to be a 
messenger from hell as a ministering servant from heaven. 
Medical legislation in this country has been nothing less 
than a farce, partly because the general public is not aware 
how abased the profession is, and partly that Americans 
are extremely jealous of what they term personal liberty. 
It is being attempted to remedy some of the abuses of the 
medical profession by regulating the practice of medicine 
by State Examining Boards. Experience has demonstrated 
that these boards are but the excrescences of the various 
medical colleges, who are themselves the root of the very 
evils that are sought to be remedied. The duties of these 
boards are simply to make themselves officious, and to in- 
quire into the source of the credentials or diplomas of the 
applicants for a license to practice medicine, and not into 
the qualifications or competency of the applicants. All that 
is necessary under such laws is simply to present a diploma 
of some sort ; whether it was stolen, or the diploma of a dead 



30 HOME TREATMENT. 

man, or gotten from any of the numerous worthless colleges, 
is not made the subject of inquiry ; and as by far the greatest 
number of quack-salvers in this country have diplomas, the 
law falls short of remedying quackery. 

There are, usually, enough boards of examiners, represent- 
ing the different schools, so that the different interests of the 
diploma manufacturers are well represented. A medical 
examining authority whose functions and powers do not 
go higher or beyond the mere granting of licenses, or which 
does not examine into the qualifications of the persons who 
possess diplomas, is utterly absurd, because it is no protec- 
tion against ignorance and imposition. A law that pre- 
sumes that all persons holding diplomas are qualified and 
competent to practice medicine, is essentially -wrong, or 
inadequate to fulfill the purpose for which it was designed. 
I have known graduates from what were considered good 
colleges who could neither write a safe prescription nor diag- 
nose a case. 

There is only one way towards an approach to an efficient 
and intelligent board of medical examiners, and that is, one 
single State board in which the different schools may be 
represented as to their pet theories of prescribing medicines, 
but in all other departments of medical science and art 
there must be a uniformity of talent and qualification. 

There must be a standard of excellence established by the 
State, which is higher than and above the recognized stand- 
ard of any medical college, for no medical college is trust- 
worthy in this respect. 

The State in its sovereignty must prescribe what shall 
constitute a medical education, and the requirements should 
be embodied in the statutes. A license or degree from that 
source, after a final examination, should be the only legiti- 
mate license to practice medicine. 

Such a method would establish a system that would 
clearly define the status of every medical practitioner. The 
board must have the power, and it must be their duty, to 
examine each and every applicant for a license, as all 



THE REASON WHY. 31 

candidates for the army medical service are examined. All 
this noise and talk about a preliminary examination and 
an extended course of medical study are simply the vaporings 
of superficial minds. It is neither the preliminary course, 
nor the length of time that a person consumes in trying to 
become a doctor, in which the public is interested, but what 
kind of doctor a person is when he hangs out his shingle 
and begins to practice, whether he is competent to do that 
which is expected from him in the hour of sickness or great 
peril, irrespective of any diploma or any medical college. 
Foreign graduates should be amenable to the same exam- 
ination, for behind these, too, belongs the interrogation 
point. The gushing mediocrity of some of these diploma 
holders gives rise to the suspicion that their credentials are 
not genuine. 

As an American to the manor born, I would not for a 
moment deny the humblest citizen an opportunity to ele- 
vate himself to the highest professional honors; but why 
can he not be required to thoroughly equip himself and 
prove, by oral and written examinations on subjects of 
preliminary education, that his mind has become disciplined 
for broader or special studies, irrespective of any course in 
a college? After the State has satisfied itself of the profi- 
ciency of the applicant in scholastic acquirements, it should 
go further, and examine into the qualifications for a degree 
of medicine, just as they do in the U. S. Army, only with 
this exception, that no diploma of any medical college 
should be required from the candidate, and if he has one it 
should not be recognized. 

This would simply incorporate in the State laws the 
distinctive feature of the University of London, which ex- 
amines and confers graduation on persons who have received 
instruction in such institutions at home and in the colonies 
as have satisfied a Secretary of State with regard to their 
studies. 

This university also has and exercises a power of exam- 
ining for degrees persons who have not been at any institu- 



32 HOME TREATMENT. 

tion. Nothing could be more democratic than for the State 
to make such a provision for State medical examinations. 
The German Government does precisely the same thing, 
with the exception that it makes graduation from the med- 
ical department an essential prerequisite. It has a State 
board of examiners to examine all graduates in medicine 
of their own universities, to further prove if they are really 
qualified. A diploma in Germany is of no value ; it is the 
so-called serzliche Approbationspruefung, State's examination, 
that gives the license to practice legally. 

When this is found necessary, notwithstanding the high 
standard of German medical schools, how much more is this 
safeguard against incompetency needed with us ? I have 
endeavored to prove from the methods of Germany and the 
course of the United States medical department that di- 
plomas cannot be accepted as bona-fide evidence of a medical 
education. With us a half dozen doctors can get together 
any time, incorporate a medical college, call themselves pro- 
fessors, and start out advertising themselves and their col- 
lege for the purpose of manufacturing diplomas and doctors. 
Why, a diploma under these conditions should not be worth 
the parchment it is written on, as evidence of a medical 
education, unless attested by a higher and perfectly inde- 
pendent authority ! 

If the public once understood that too many doctors are 
dangerous to the morals and health of society, they would 
be quite as anxious as the most enthusiastic medical edu- 
cator to remedy the evil. 

The question of too many doctors is one of economical 
and social science, not of medical science, and, therefore, it can 
only be intelligently considered from these philosophical 
standpoints. It is a well-understood and accepted law of po- 
litical economy that in the industrial pursuits, whether in the 
manufacturing departments or in agricultural production, 
the surplus or glut in the market of any of the products of in- 
dustry, reduces the price and stimulates consumption, which, 



THE REASON WHY. 33 

in the course of time, is regulated by a suspended or reduced 
production, thus restoring a healthy equilibrium. It would 
be an absurdity to apply the same rule to a surplus of doc- 
tors, because human ills or diseases do not increase in pro- 
portion to the surplus of doctors, nor will fees be any less. 
But the surplus, in order to live, must live on the earnings 
of the community, and here the disastrous consequences 
appear. 

The credulous, and those who often may imagine that 
they require medical advice, become the unconscious victims 
of the unhealthy disproportion, for the doctor seizes the op- 
portunity to make a case, while the normal proportion of 
cases do not reach around. Thus, it is calculated that at 
least fifty per cent, of all the diseases for which patients are 
treated are fictitious as far as actual disease is concerned, and 
the remaining fifty per cent, are, in the majority of instances, 
overdosed and overdoctored. For this reason medical legis- 
lation would not make a privileged class of physicians, nor 
throw unusual safeguards around medical practitioners, but 
medical legislation is to protect the people themselves from 
imposition and quackery. 

The reason for the overcrowded state of the profession is 
not alone the laxity of medical laws, or the low standard of 
medical education in most of our colleges, but the general 
tendency of the country population to drift into the cities. 
Honest labor has not the dignity which its importance de- 
mands, and a radically faulty method of common-school edu- 
cation is another reason. Utilitarian manual methods, in 
which the hands are educated for useful employment and 
the minds to habits of industry, are to be wished for. Young 
men who have acquired a technical education in mechanics 
and arts will learn to respect labor in every department, 
and their ambition in life will be greater than to swing a 
cane or wear a silk tile. 

In proportion as the productive employments are made 
respectable, this questionable ambition to become M. D.'s will 
fall off. o 



34 HOME TREATMENT. 

History tells us that the Opulence of Eome was speedily 
accompanied by a decline of its agriculture, after which 
came the fall of the Roman Empire, because the country 
population became too indolent and restless and nocked to 
the cities for an easier and luxurious living. History in 
this respect seems to be repeating itself. We are always 
talking of encouraging the beauty and growth of our cities, 
but not one word of encouraging agriculture ; no one talks 
of encouraging farm life and making it profitable and attract- 
ive, so that men and women would prefer the more inde- 
pendent subsistence in the country to a shabby gentility in 
the city. Some reader may ask, What has all this to do with 
doctoring ? I say that the answer must already have been 
apparent ; it becomes the duty of everyone to interest him- 
self, that the division of labor shall be apportioned sd as to 
do the greatest good to society. 

We have a national characteristic which shows itself in 
an abnormal conceit for everything American in a degree 
that is not essential for true patriotism and love of country. 
But when by comparisons we learn that there are abuses 
and errors which are destructive to a healthy intellectual 
and material growth, we must have the honesty and inde- 
pendence to acknowledge them, and busy ourselves to find 
a remedy for existing evils. 

The physician who can assist in the amelioration of 
society by administering to human ills which are the result 
of unwise laws, is accomplishing as much good as if he 
writes prescriptions or bleeds patients. The sooner every- 
body recognizes the fact that the time has come to deflect 
the current of ambition from the practice of medicine as a 
means of making a living, the sooner will untold suffering 
be lessened, and there is no honest-minded physician who 
does not heartily agree with me. Mercenary persons, and 
ignorant or unscrupulous doctors who run diploma mills, 
may criticise severely the honest sentiments here expressed, 
but the truth is so apparent, that he who runs may see 



THE REASON WHY. 35 

the inevitable consequence of this unhealthy competition. 
Professors of colleges have a direct interest in the ignorance 
and incompetency of their graduates, because they are the 
means of calling them into consultation on every possible 
■occasion in trifling ailments, and if the disease belongs to 
some specialty, they have the cases entirely turned over to 
them, because, in the mind of the incompetent and newly- 
made doctor, the professor who was the means of getting 
him a diploma, poses as the beau ideal of medical wisdom. 
In this way it becomes exceedingly profitable to be a pro- 
fessor. If there are not enough medical colleges in a com- 
munity to afford places for the ambitious, it is considered to 
be one of the best-paying financial investments for a com- 
pany of physicians to start one, and in most of these con- 
-cerns it is easier to get a diploma as a doctor than to learn 
to be a good dressmaker or shoemaker. 

Hence there is only one remedy to control the educa- 
tional aspect of this evil, and that is to take medical colleges 
entirely out of the hands of private individuals and make 
the State the only source of the necessary credentials to 
practice medicine. 

An American system of medical education fostered by 
the State would be productive of grand results, because, 
under the shadow of our free institutions, the mind tran- 
scends the circumscribed sphere of despotism. This has 
already been proven in numerous instances, notwithstand- 
ing unfavorable surroundings. 

Forming the galaxy of great names that illumine the 
milky way of science, there are none brighter than a Gross, 
a Flint, a Sims, and some others. These were great Ameri- 
can authors and physicians, who never pretended anything 
else ; they never dreamt of the Don Quixotic escapade of 
pretending to be American professors while they appended 
to their names initials or abbreviations of questionable 
credit from foreign institutions. The brilliancy of true 
genius w T as their only passport to fame. 



CHAPTER II. 

DELUSIONS AS TO THE CURATIVE VALUE OF 
DRUGS. 

Medicines that are sure cures for all the diseases to 
which humanity is heir, are not the spurious discoveries of" 
the quacksalver and patent-medicine vender alone, but 
some very intelligent persons believe that if there is not a 
panacea, there is at least a remedy, for every disease. In 
cases where the patient does not recover, they believe that 
either the disease was not thoroughly understood or the 
medicines which were given were not properly selected. 

This is a great error, because there is no such thing as a 
specific or infallible remedy for any disease, and, on the 
other hand, it is quite possible that most patients, with 
proper nursing and diet, would naturally recover without 
any drugs or medicines whatever. Outside of those drugs, 
like ether, chloroform, opium, or morphine, that are em- 
ployed for the purpose of deadening the sensibility of the 
nerves, so as to render them insensible to pain, there is not 
another drug that is absolutely sure and true in its medical 
effects. Some few are very useful at times, but the great 
bulk of medicines do much more harm than good. 

Medicine in its broad sense means a knowledge of the- 
cause, course, treatment and ultimate results of disease. 
The study of medicine cannot be circumscribed by dogma 
or theory, nor can it be mastered in a few short years of 
study at the very best medical schools. It requires a mind 
adapted by nature for a plodding investigation of her laws,, 
and incessant application, long after the college curriculum 
is ended. In fact, the student must unlearn much of the 
(36) 



DELUSIONS AS TO THE CURATIVE VALUE OF DRUGS. '57 

stereotyped lessons of the text-books, and this is particularly 
true of the supposed medicinal effects of drugs, which are 
always exaggerated. When physicians really have a threat- 
ening case, under their observation and care, the attributed 
therapeutic action of drugs is nearly always disappointing, 
and very often injurious, and they are forced to let the drug- 
ging entirely alone, and bring their skill to bear on meas- 
ures which support the strength and vitality of the system, 
so that nature can effect a cure in her own way. This 
may seem to some simple doctoring, but I can assure the 
reader that it requires the highest degree of medical skill, 
notwithstanding the droll sarcasm of Voltaire, that "medi- 
•cal science is the art of amusing the patient while nature 
performs the cure." There is neither skill nor much learn- 
ing required to give an ordinary prescription; that the aver- 
age apothecary could do with the greatest exactness. But 
science and medical skill can be exhausted in managing 
and husbanding the resources of nature, in order to effect 
a cure. 

Medicine no longer stands alone as a simple art, based on 
theoretical deductions, as it was less than a hundred years 
ago, but it has become a department of natural science, a 
part of the natural history of the human race. 

Disease is as much a vital process as health, only in one 
case the vital function is perverted, or destructive, while in 
health it is constructive. The germ theory of disease and 
cellular pathology are clearly within the domain of bio- 
logical research, while chemistry has solved many phys- 
iological processes. Mental philosophy has been no less 
serviceable in the department of medicine, by teaching the 
wonderful influence of thought and emotions on the phys- 
iological functions of the organs. 

A one-sided education is inadequate to appreciate the 
subject of healing or teaching. A comprehensive knowl- 
edge of all that bears on the subject of health and disease 
has several important objects in view, namely, it thoroughly 



38 HOME TREATMENT. 

acquaints the doctor with all of nature's resources for the 
amelioration or cure of disease; and it gives him judgment 
in all cases to avoid irreparably wrong treatment, which 
places obstacles in the road of nature's efforts to heal 
spontaneously. The quack or professional imbecile will, 
in the ordinary course of diseases, be accredited with remark- 
able cures; in fact, the cures wrought by a quack or an 
ignorant person are just as welcome and valuable to the 
patient interested as if they were accomplished under the 
advice of the most erudite and skillful physician, but the 
invalid ran the chances of malpractice or bad treatment 
at the hands of the quack, which might have cost him his 
life, because the incompetent healer does not know when his 
method of treatment does mischief. Every method of cure 
may possess merits of its own, which are beneficial when 
the disease or conditions for its employment are present, 
whether this is mind cure, water cure, or anything else that 
you may name. All that any system of treatment can do 
is simply to stimulate the curative force of nature, which is 
the only first cause of any cure. 

The reparative energy of nature has never been duly 
recognized, because the selfishness and pride of the doctors 
will not concede this as often as they ought. The doctor 
should be the most useful as a monitor to the sick, in guid- 
ing and controlling thought and conduct, in harmony with 
the curative energy of nature. From this point of view the 
pretensions of anyone effecting this or that cure are only 
a delusion, because the doctor effects nothing, he only assists, 
guides, and directs towards effecting a cure. What this cur- 
ative force is has by no means been understood. Some 
believe it identical with life or vital action, which manifests 
itself only in organized substances, but even if we admit 
this identity, we are balked again, because we do not really 
know what life is, any more than we know what electricity 
is. Descartes resolved life into matter and motion; this, 
however, is rather the phenomena of life and gives us 



DELUSIONS AS TO THE CURATIVE VALUE OP DRUGS. 39 

no idea of the real essence of the force that we call life. 
There is another theory, that all life whenever or wherever 
found is a spiritual force, ethereal and universal. For our 
purpose, the discussion of this question has no particular 
value, were it not for the fact that life, or vital activity, 
wherever we find it in organized substances, whether in the 
lowest living thing or in the highest type of physical devel- 
opment, is accompanied by or is endowed with the natural 
tendency to repair defects or injuries in that in which it is 
active. 

Regeneration, or the curative process of nature, is always 
the handmaid of vital activity. It is present at the earliest 
formation and division of a cell, which constitutes the unit 
of all organisms. Just as one brick is laid on the other with 
mortar or cement between them, so as to make a whole wall 
of a building, so are our bodies built up of minute cells, one 
added to the other, with cement between them, until the 
entire structure is completed. There is no tissue of the liv- 
ing body which was not at one time during its existence a 
cell. This curative force is beautifully illustrated in the 
lower animals, where parts of organs are replaced to a far 
greater extent than among warm-blooded animals. 

Professor L. Landois, in his work on " Human Physiology," 
says that "when a hydra is divided into two parts, each 
part forms a new individual — nay, if the body of the animal 
be divided into several parts in a particular way, each 
part gives rise to a new individual. The planarians also 
show a great capacity for producing lost parts. Spiders and 
crabs can reproduce lost feelers, limbs, and claws; snails, 
part of the head, feelers, and eyes, provided the central nerv- 
ous system is not injured. Many fishes reproduce fins, even 
the tail fin. Salamanders and lizards can produce an entire 
tail, including bones, muscles, and even the posterior part 
of the spinal cord, while the triton reproduces an amputated 
limb, the lower jaw, and an eye. This reproduction re- 
quires that a small stump be left, while total extirpation of 



40 HOME TREATMENT. 

the parts prevents reproduction. In amphibians and rep- 
tiles the regeneration of organs and tissues, as a whole, 
takes place after the type of embryonic development, which 
is by cell division, and the same is true as regards the his- 
tological processes which occur in the regenerated tail and 
other parts of the body of the earth worm." Comparative 
pathological anatomy clearly demonstrates the inherent 
curative power of nature, and this is also apparent in the 
vegetable kingdom, and together they deliver a lecture on 
the "art of healing" from the stage of creation, in silent and 
modest language, but eloquently instructive to the thought- 
ful observer. 

The question now naturally arises How far this curative 
energy of nature operates in warm-blooded animals, and 
especially in man ? The answer must be that, while it falls 
short of reproducing parts of organs or even tissues in the 
same degree of perfection as in the lower orders, the innate 
tendency towards regeneration and recovery from injury 
and disease is, on certain lines, practically the same. There 
is not the slightest doubt that ninety per cent, of all cures, 
whether the invalid took this, that, or the other medicine, or 
whether the method of treatment was homeopathic, allo- 
pathic, or mind cure, are entirely due to this inherent cura- 
tive energy; and the other ten per cent, may have required 
some active remedy, but this, too, alone, without nature's 
healing force, would have been ineffectual. 

What is ordinarily termed mind cure is not mind cure 
in the sense that the term implies, but it is simply the mind 
toying or playing with the idea of a cure, for while the mind 
is thus engaged, nature's energy is accomplishing the result 
or cure. This is the only rational explanation, and corre- 
sponds with the cures that nature is continually making in 
the lower orders of animals. If the recovery of the sick 
depended entirely upon the caprice and wisdom of the 
doctor, and not on the reparative forces of nature, the race 
would soon die out. I fully recognize the fact that the cur- 



DELUSIONS AS TO THE CURATIVE VALUE OF DRUGS. 41 

ative force can be stimulated; this may be done through the 
influence of nourishing food, alcoholic stimulants, a drug or 
medicine, or through purely mental influences. No physi- 
cian can estimate how much merit he can accredit to the 
methods or substances he employs in any particular case 
that recovers, and how much to the lady physician, Dame 
Nature. This old lady doctor is ever active, and the most 
inert drugs, employed or administered with her assistance, 
have achieved wonderful cures; this the history of medicine 
confirms. The tar water cure of Bishop Berkeley is an 
illustration how an inert substance is capable of making for 
itself an enviable reputation for curing ailments, like pleu- 
risy, pneumonia, erysipelas, asthma, indigestion, hypochon- 
dria, and other diseases. This remedy had the vehement 
indorsement of one of the greatest metaphysicians of the 
English-speaking world, and that the cures reported by him 
were genuine no one will doubt for a moment; but the 
bishop, like many of our day, was determined to have a 
remedy to cure disease, where none was required, but the 
mind had to be humored, while nature was actively repair- 
ing the disorder. To-day almost everyone is satisfied, that 
the virtues ascribed to tar water by Berkeley were a delu- 
sion, which was shared by all those who believed as he did. 
The Weapon Ointment affords another instance where 
the credulity of the public was supported by abundant facts 
to prove the efficacy of the remedy, yet it was based on the 
wildest superstition. This ointment was employed for the 
healing of wounds, but instead of being applied to them, the 
weapon with which the wound was inflicted was carefully 
anointed and hung up in a corner, and the wound was 
w r ashed and bandaged without the salve being allowed to 
touch it. This ointment created such a furor that eminent 
medical men indorsed its virtues as a healing agent. An- 
other example of superstition and charlatanry was the 
equally famous Sympathetic Powder, which, when applied 
to the blood-stained garments of wounded persons, cured 



42 HOME TREATMENT. 

their injuries even when miles away. That dukes and 
knights vied with each other to obtain the secret of its 
preparation and ingredients is a matter of history. In- 
stances of delusions on medical subjects could be multiplied 
a thousand fold, but they prove nothing but ignorance and 
superstition on the one side, and the inherent all-powerful 
curative force of nature on the other. While I wish to 
avoid wounding the fastidious and sensitive in the matter 
of their faith in their cherished system of cure, I cannot 
refrain from classing homeopathy as a similar delusion. 

I am glad to admit at the outset that I have read 
Hahnemann's " Organon of the Art of Healing" with a great 
deal of interest and some profit. I am convinced that his 
theory of infinitesimal dilutions is as absurd and ridiculous 
as either the Weapon Ointment or the Sympathetic Powder 
treatment already referred to. 

If we consider the harsh, or, preferably-termed, heroic 
treatments, then in vogue, we need not be surprised that the 
pendulum of medication should have swung in the opposite 
extreme. Blood was drawn from the already enfeebled 
body, emaciated by disease; emetics were administered to 
sensitive and inflamed stomachs, and only aggravated into 
greater disorder; blisters, or the burning moxa, scorched into 
greater agony the suffering mortal, while large doses of 
drastic cathartics depleted the waning forces of nature. 
There was a tendency of the medical profession about that 
time to entirely ignore the curative forces of nature, and to 
attack disease as you would a midnight marauder, with the 
most powerful and dangerous weapons at command; and 
there is no doubt that with these powerful expedients, diseaso 
was destroyed, but life also. Under these conditions Hahne- 
mann appeared on the scene, and I am frank to admit that 
he rendered suffering humanity invaluable service by es- 
pousing a system of cure which had the merit of being 
harmless. If we take into account that physiological studies 
were then in their infancy, and that the word "Biologie," 



DELUSIONS AS TO THE CURATIVE VALUE OF DBUGS. 43 

from the Greek words which signify a discourse upon life 
and living things, was made use of for the first time by 
Lamarck, in a work published in 1801, it will not seem 
altogether strange that even learned men were mystified 
into beliefs which, in the light of our present knowledge of 
the subject, appear preposterous. This was a most oppor- 
tune time to fasten on the healing art any doctrine or 
dogma, however absurd, and on this tide of ignorance and 
superstition, the doctrine of infinitesimal dilutions floated 
into popularity. Homeopathy affords us one of the most 
striking illustrations of the uselessness of drugs in ordinary 
ailments, and conclusively proves that nature possesses in- 
herent curative powers. Cases treated under this system 
make splendid recoveries, and often much better than when 
the powers of nature are opposed or weakened with nauseat- 
ing drugs and poisonous doses, prescribed by incompetent 
persons. 

Hahnemann truthfully observed that existing diseases 
are liable to become aggravated, complicated or replaced by 
drug diseases. 

There is no doubt of the truth of this statement where 
drugs are heedlessly administered. When I was a student 
I was told that calomel was par excellence a babies' medi- 
cine without any qualification. I was credulous enough 
to believe it and prescribed it for my own children for its 
purgative effect whenever it was deemed necessary. In later 
childhood ; when the second dentition set in, the germs of 
the permanent teeth were so injured, evidently from the 
calomel that had been absorbed into the system, that 
the teeth were ragged and defective. The glands of the 
neck were also inclined to swell and suppurate, and there is 
no doubt in my mind that a great deal of what is generally 
supposed to be scrofula in young children, is nothing more 
nor less than a "drug disease." I believe that Hahnemann 
was cognizant of the potency of nature under ordinary cir- 
cumstances to cure disease. I believe that he absorbed this 



44 HOME TREATMENT. 

view of the philosophy of healing from the writings of Para- 
celsus, which he had studied, and from which he drew his 
inspiration, but he also appreciated the practical necessity 
that success depended on satisfying the superstitious belief 
of the times, and that consisted in offering some tangible 
remedy. Hahnemann proved himself equal to the emergency 
by formulating his doctrine of potentizing drugs or medic- 
inal substances by reducing them to a wonderful degree of 
minuteness. 

The preparation of these dilutions was directed to be 
carried out in a ceremonial sort of way. Chalk from an 
oyster shell, sulphur, charcoal, or any other substance, was 
potentized by taking one grain of the drug and mixing it 
with one hundred grains of sugar of milk. Of this mix- 
ture one grain was taken and mixed in the same manner 
with another hundred grains sugar of milk. This gave the 
ten-thousandth of a grain of the drug. Take one grain of 
this with another hundred grains of sugar of milk and 
the powder will contain the millionth of a grain of the sub- 
stance, or the first potency, which forms the bases of other 
dilutions. This is reducing the doses of any drug to an ab- 
surdity, and Hahnemann was too brilliant a mind not to 
know this. It might be mentioned in connection with these 
dilutions, that if one grain of the most powerful drug, strych- 
nine, aconitin, arsenic, or any other chemical that is known, 
is mixed with six hundred grains of sugar of milk, one 
grain of this powder, or the one six-hundredth of a grain of 
this substance, cannot be detected by any test or chemical re- 
agent; or, in other words, the quantity of the drug or chemical 
contained is so small that the most delicate chemical test fails 
to show it; yet, in homeopathy, the dilutions are carried to the 
decillionth of a grain, from which important medical effects 
are expected. 

Drugs are physical agents, and if they are diluted so 
as to destroy their chemical or physical properties, it is sheer 
nonsense to expect any physical result from them on the 



DELUSIONS AS TO THE CURATIVE VALUE OF DRUGS. 45 

system. Chemical and physical facts conclusively prove the 
litter inertness of certain drugs either in themselves or in 
the manner in which they are employed, and the indisputa- 
ble evidence of biological science demonstrates the natural 
curative tendency of nature observable in the lowest living 
thing to the highest, so that we should stultify our reason 
were we to arrive at any other conclusion than that the 
doctrine of this therapeutic creed is one of the most irrational 
delusions that ever befogged the mental horizon of a think- 
ing being. 

The supposed cures effected through the employment of 
the Weapon Ointment, the Sympathetic Powders, the end- 
less dilutions of the Hahnemann system, and, indeed, most 
other remedial agents from any school or source, whether 
offensive powders, mixtures, or patent medicines, or the 
more agreeable and tasteless pellets, have but one role to play, 
that is, to assuage the apprehensions of the mind while 
nature is performing the cure; that is, to engage the 
mind with the thought or idea that something tangible is 
being done to bring about a certain result. 

If the patient has pinned his faith to the curative value 
of mind alone, the mind is for the time being engaged 
with idea that mind is performing the cure. This is a de- 
lusion quite similar to the previous one, in which medicines 
are taken, with only this difference, that while you pin your 
faith on drugs in the one case, you pin it to mind cure in 
the other. 



CHAPTER III. 

WHAT IS MIND CURB? 

This subject has given rise to an endless variety of con- 
tradictory discussions, and while it has won for itself fanatical 
devotees on one side, it has been ridiculed on the other. This 
is not at all surprising, when an inquiry is made into the 
competency of the parties to the controversy. To be in- 
formed in metaphysical philosophy, or fully equipped in 
scriptural lore, but without a practical study in the art and 
theory of medical science, precludes the possibility of pre- 
senting the theme in a logical manner, or establishing a rele- 
vancy between medical science and mind cure. A medical 
education that is based on strictly physical characteristics of 
disease, as they are studied at the bedside, or in a microscop- 
ical laboratory, is equally inadequate; for the question of 
mind cure goes beyond the physical into the metaphysical, 
and not until the operations of the mind have been closely 
followed to the bodily or organic functions, can the intimacy 
of their relations be thoroughly appreciated. Medical men 
betray their incapacity for observation if they contemptu- 
ously dismiss the subject of mind cure by some superficial, 
disparaging illustration, for there is much more in the sub- 
ject than is dreamt of, even in the mind of the average 
college professor. 

"The mind," says Dr. W. F. Evans, "can be made the 
plastic or formative principle of the body, and that thought 
can retard, pervert, or stimulate and correct the different 
functions of the human organism." The relation of spirit 
and matter is very intimate, and some very clever thinkers 
resolve all matter into spirit, in its ultimate analysis. 
(46) 



WHAT IS MIND CUEE? 47 

Bishop Berkeley affirms this in his "Principles of Hu- 
man Knowledge." In section seven he says "there is not 
any other substance than spirit." 

If we view nature from a materialistic standpoint, we 
see only one-half of what we think we do, and even that 
must be very imperfectly judged by our senses. Friedrich 
Wilhelm Joseph Schelling states the relation of matter and 
spirit, in very simple and plain words, so that a child can 
understand what he says: "Nature is spirit visible, and 
spirit, is invisible nature." This may be illustrated in phys- 
ical science from what chemistry teaches of the physical 
properties of the diamond, whose atoms or molecules are so 
perfectly continuous and closely aggregated that it forms one 
of the hardest substances known to physicists. These atoms 
of pure carbon may be made to repel each other, so that the 
diamond assumes a gaseous state, which is imperceptible to 
our senses. 

I am aware that the definition of a gas is not that which 
metaphysicians would accept as applicable to spirit, and 
3'et it illustrates the idea from a physical standpoint. It is 
much better to illustrate a question with something with 
which people are generally familiar. The body and every 
organ and tissue forming a constituent part of it, is simply 
the plain ordinary matter in motion, vitalized by what we 
call life, and this life principle is a mystery, and what is true 
of the diamond is true of the human body in its entirety. 
If placed in a crematory, it is reduced to a few ounces of 
bone ash, and, with the addition of a little acid, this too 
would soon disappear into invisible gases, so that the doc- 
trine of philosophers, that matter is spirit, is, after all, not 
so far removed from physical evidence. 

Physiological science gives abundant proof that the mind 
has a powerful influence over the body. By mind is meant 
all that class of mental phenomena called reason, and the 
emotions and passions. Doctor Evans says " the body is in- 
cluded in the being of the mind," or, in other words, that 
matter is included in the being of spirit. 



48 HOME TREATMENT. 

The thinking quality of the mind is undoubtedly the 
mainspring of its action, of which the formation of ideas 
is the highest kind of mental activity. These originate 
either within the mind or are brought within its sphere by 
transformed impressions from without, but through the 
power of the Will these are more or less modified, and may, 
indeed, be entirely suspended, so that the mind may become 
entirely passive and not think of anything. It is the exer- 
cise of. this Will power which may make the operations of 
thought conducive to health or disease. 

Cogito ergo sum, " I think, therefore I am," is a maxim of 
Descartes. What we think and give shape to in thought 
has for us a real existence, and we have it in our power to 
create thoughts that will have either a painful or pleasur- 
able sensation. Painful sensations have occurred to persons 
by the conviction of the existence of a cause which would, 
when present, have produced certain results. Of this sev- 
eral examples are given in W. B. Carpenter's physiology: 
"A clergyman told me that some time ago suspicions were 
entertained in his parish of a woman who was supposed to 
have poisoned her newly-born infant. The coffin was ex- 
humed, and the coroner, who attended with the medical 
men to examine the body, declared that he already perceived 
the oder of decomposition, which made him feel faint, and 
in consequence he withdrew. But on opening the coffin it 
was found to be empty, and it was afterwards ascertained 
that no child had been born, and consequently no murder 
committed." The second case is yet more remarkable: 'A 
butcher was brought into the drug store of Mr. Macfarlan, 
from the market-place opposite, laboring under a terrible 
accident. The man, on trying to hook up a heavy piece of 
meat above his head, slipped, and the sharp hook penetrated 
his arm, so that he himself was suspended. On being ex- 
amined he was pale, almost pulseless, and expressed himself 
as suffering acute agony. The arm could not be moved 
without causing excessive pain, and in cutting off the sleeve 



WHAT IS MIND CURE? 49 

he frequently cried out. Yet when the arm was exposed, it 
was found to be quite uninjured, the hook having only trav- 
ersed the sleeve of his coat." In this, and similar cases, the 
sensation was perfectly real to the individual who experienced 
it, but it originated in the mind by an impression through 
the nerves of internal sensation which created the idea 
or image in the brain, and the external senses to which 
it was referred had nothing to do in causing the feeling. 
Diseases are thus created every day, either by ourselves or 
by those to whom we go for advice. I call to mind a lady 
who had gone to a distinguished practitioner for a supposed 
womb disease for some six months. She experienced no 
change for the better, but kept on growing continually 
worse, so that she no longer had a refreshing sleep, and her 
appetite for food was entirely gone. On examination I 
found her womb entirely healthy, in fact, exceptionally so, 
thanks to her attending physician, because, after a certain 
amount of useless doctoring, the rule is quite the other way. 
I told this lady of her error or delusion respecting her womb, 
and prescribed a quieting mixture for the night and a tonic 
for the day. She began at once to improve, and when I 
saw her again, six weeks afterwards, she had so fleshed up 
that I failed to recognize in her traces of her former delu- 
sion. The disease of which this woman was suffering was im- 
aginary, and had no real existence for anyone outside of her- 
self. She was the victim of the harrowing symptoms which 
her mind conjured into shape, and an attempt to brush aside 
the disease, with the flippant remark that "there was noth- 
ing the matter with her," would have been cruel, unscientific, 
and absurd. The ailment which she thought she had, had 
as much an existence as though the most malignant disease 
was destroying her life ; for her imaginary disease was doing 
the same thing, only in a different way. 

Imagination is the most powerful function of the human 
brain. Associated with thought, it constitutes the empire 
of the soul, which recognizes neither time nor space. With 
4 



50 HOME TREATMENT. 

it we are brought into communion with everything that is 
grand and beautiful in nature. Imagination is the archi- 
tect of our souls; it continually creates and projects into the 
beyond; it enlarges the sphere of our thought in building 
up artificial structures for our pleasure and entertainment. 
When it becomes perverted and abnormal from false im- 
pressions, either through the nerves of internal sensation or 
through the nerves of external sense, or, what quite often 
occurs, from morbid thoughts or ideas received from others, 
it becomes equally potent in causing misery and disease. 

Expectation or attention influences, in a remarkable de- 
gree, the bodily functions. There are a great many persons 
who keep themselves in misery and disease by always think- 
ing of their imaginary or real sickness. I had a profitable 
experience some years ago in my own case, which conclu- 
sively proved to my mind the aggravating tendency which 
constant attention has on disease. I had contracted an ordi- 
nary catarrh of the pharynx, or what is generally called a 
sore throat. At first I did not mind it, but in the course of 
time, from continued exposure in all kinds of inclement 
weather, at all hours of the day or night, it fastened itself 
upon me so that it was at times very annoying by its dry- 
ness and pain. I do not know of anything that I did not 
use, but, after a trial of several years, I was convinced that 
the more I looked at it and the more I treated it with sprays, 
gargles, etc., the worse it became, so that one day I resolved 
to let it alone, and not think about it. I took a teasponful 
of glycerine once in a while when it became too dry. For 
years I have not looked at it, and for all I know, it is per- 
fectly well. I stopped bundling up my neck, used light 
bedcovering, so as not to sweat, and by this simple method 
accomplished what the very best selected drugs utterly 
failed to do. 

The great English authority, Daniel Hack Tuke, in his 
work, " The Influence of the Mind on the Body in Health and 
Disease," quotes from Unzer's work, published in Germany in 



WHAT IS MIND CUKE? 51 

the year 1771: "Expectation of the action of a remedy often 
causes us to experience its operation beforehand." And 
John Hunter said as early as 178G: "I am confident that 
I can fix my attention to any part until I have a sen- 
sation in that part." A great number of cases are recorded 
where complete insensibility to bodily pain has been induced 
without the use of drugs. The intention of administering a 
•certain drug was made known in this manner. Bread pills 
have acted as decided cathartics, and an empty chloroform 
•or ether bottle put the sensitive into a profound stupor or 
insensibility. 

Dr. Woodhouse Braine, of the Charing Cross Hospital, 
writes: "During the year 1862 I was called upon to give 
■chloroform to a very nervous and highly hysterical girl, 
who was about to have two fatty tumors of the scalp re- 
moved. On going into the operating room, it was found 
that the bottle containing the chloroform had been removed 
to the dispensary, and on testing the Snow's inhaler, which 
at that time I was in the habit of using, I found it to be 
•quite devoid of even any smell of chloroform. Then, hav- 
ing sent for the bottle, in order to accustom the girl to the 
face-piece, I applied it to her face, and she at once began to 
breathe rapidly through it. When she had done this for 
about half a minute, she said, 'Oh, I feel it, I feel I am go- 
ing off,' and as the chloroform bottle had not arrived, she 
was told to go on breathing quietly. At this time her hand, 
which had been resting across her chest, slipped down by her 
side, and as she did not replace it, I thought I would pinch 
her arm gently to see the amount of discomfort her hysteri- 
cal state would induce her to bear. She did not notice a 
gentle pinch, and so I pinched her harder, and then as hard 
as I could, and to my surprise I found that she did not feel 
at all. Finding this was the case, I asked the operator to be- 
gin, and he incised one of the tumors, and then, as the cyst 
was only slightly adherent, peeled it away. At this time I 
liad removed the face-piece, and, wishing to see the effect of 



52 HOME TREATMENT. 

her imagination, I said to the operator, who was going to 
remove the second tumor, ' Wait a minute ; she seems to be 
coming round.' Instantly her respiration, which had been 
quite quiet, altered in character, becoming rapid as when I 
first applied the inhaler, and she commenced moving her 
arms about. I then replaced the face-piece, and her breath- 
ing again became quiet, and she submitted to the second 
operation without moving a muscle. When the water dress- 
ing and bandages were applied, in answer to the question as 
to whether she had felt anything, she said, ' No; I was quite 
unconscious of all that was done.' " The mental phenomenon 
that we observe in this case clearly shows how completely 
the sensation of the patient was suspended by the imaginary 
chloroform, which existed only in her mind, yet the real 
drug could not have been more potent in its effects. 

Phenomena of the same mental process, like the different 
colors of the solar spectrum coming from one source, consti- 
tute the different stages or degrees of what is generally 
called mesmerism or somnambulism, until the sensitive ar- 
rives at that condition of complete double consciousness now 
commonly called hypnotism, in which state the will 
power of the person becomes entirely suspended, so that he 
acts only from suggestions of another person, regardless of 
propriety or consequences. When a subject who has been 
completely hypnotized is restored to his normal condition,, 
he remembers nothing of what has transpired during the 
somnambulistic state. We all have acquaintances of whom 
we speak as being easily led ; by that we mean that they 
have no will or mind of their own. These persons are 
truly unfortunate, because they are at the complete mercy 
of every designing person or cunning rogue. They consti- 
tute the large army of dupes who support the great number 
of idle women and lazy men, who claim to be clairvoyants^ 
life readers and fortune tellers. In sickness they are equally 
as credulous, and when they are a little out of sorts, they 
would a great deal rather be told that some dangerous or se- 



WHAT IS MIND CURB? 53 

vere illness has hold of them than to hear the truth that, 
outside of not eating properly, or clothing themselves im- 
properly, or being out late at nights when they should be in 
their beds, there is nothing the matter with them. 

These are the dupes who fill up the chairs in the doctor's 
waiting rooms, on regular days, for local or special treatment 
for diseases which could be much better treated by themselves 
at home, if they only were fortunate enough to fall into a 
physician's hands who had the honesty to tell them so. This 
can be further illustrated by an experience of which every 
one of us has been a victim at least once in our lives. When 
we were trying on a pair of new shoes, we felt that they 
pinched, or were too short and generally uncomfortable; 
but the salesman insisted that they were a "perfect fit" and 
that after a little wearing they would surely suit. The 
shoes were bought, and we were convinced, after a few days, 
that our impression of the smallness of the shoes was cor- 
rect, because they continued to pinch us; but we were for 
the time mesmerized or psychologized by the clerk into buy- 
ing what we were satisfied in our own minds to be not what 
we wanted. This should be constantly guarded against, 
and our conscious will power should always be exercised on 
all occasions. 

Parents should take particular pains to cultivate the 
will power of their children, in the right direction, of course. 
To stifle the will of children, when the exercise of it entails 
no bad consequences, is wrong, because it weakens their 
character, and makes them the prey of the wicked and 
selfish when they are grown to adult age. This influence 
which one person may exercise over another is not due to 
any particular force or magnetism, as was supposed by Mes- 
mer, and which is yet claimed by ignorant frauds and pre- 
tenders, but it is simply a suspension of your own ivill, or a 
sacrifice of force of character. Dr. J. M. Charcot, of France, 
has lately taken up this subject, and has given it a great deal 
of attention. His researches have confirmed the experiments 



54 HOME TREATMENT. 

and conclusions of Braid, an English surgeon of Manches- 
ter, who, in 1841, showed that, in order to produce artificial 
somnambulism, there was no need of any extraneous influ- 
ence, and. that any person of moderate sensibility can easily 
produce in himself the " magnetic sleep " without any aid or 
act of another. 

Braid discovered that to simply fix the eyes for a few 
minutes on some shining object, placed a little higher than 
the ordinary plane of vision, and five or six inches from the 
eyes, caused that total abstraction which Doctor Braid called 
" hypnotism," and which now, in honor of the experimenter, 
is often called "Braidism." This Doctor Charcot calls "im- 
personal " sleep, artificially produced by mechanical means. 
He remarks: "The psychic characteristic of the state of 
somnambulism is an absolute trust, a boundless credulity 
on the part of the subject toward the one who has hypnot- 
ized him. Take one example from among a thousand: I 
present to a woman patient in the hypnotic state a blank 
leaf of paper, and say to her: ' Here is my portrait; what do 
you think of it? Is it a good likeness? ' After a moment's 
hesitation she answers, 'Yes, indeed; your photograph! 
Will you give it to me?' The image being now fixed in her 
mind, I take the leaf of paper, with a private mark, and mix 
it with a score of other leaves precisely like it. I then hand 
the whole pack to the patient, bidding her to go over them 
and let me know whether she finds among them anything 
she has seen before. She begins to look at the leaves one 
after another, and as soon as her eyes fall upon the one first 
shown, she exclaims, 'Look! your portrait!'" This is the 
latest phenomenon, and proves how the mind may print an 
image on a substance, as the sun prints on a negative. 

For persons of casual thought or reading, hypnotism 
may at first appear complicated and mysterious, but if you 
will only bear in mind that the different mental processes 
operating between two persons always resolve themselves 
into a weaker will power yielding and a stronger will power 



WHAT IS MIND CURE? 55 

controlling, you have a key which unlocks the different man- 
ifestations of minds in their relations one with the other. 
This does not relate to action alone, but to the creation and 
meaning of our thoughts. 

The cures effected by the royal touch, which prevailed 
in England from the time of Edward, the confessor, to Queen 
Anne, were but a disguised hypnotism, or a sort of mind cure. 
Soothsayers, or magnetic healers, who claim a healing mag- 
netism, are either knaves or fools, and often both. They 
undoubtedly can report cures, but these are due to the nat- 
ural tendency of some diseases to get well, and to the 
hopeful thoughts which these persons inspire by their prom- 
ises of a cure ; sometimes these hopes are heightened by the 
different movements or passes which the healer makes. 
The greatest healer of whom we have any reliable record 
never claimed any abnormal power or force. Christ healed 
by the Word, that means by the thought or mind. Faith 
in anything creates a curative or healing thought in the 
mind of the patient, which stimulates the reparative or heal- 
ing force of nature, and in this manner wonderful cures are 
effected. 

The faith, or confidence, which you have in a physician 
stimulates you at once into a better or stronger feeling. 
This has been the experience of every sick person, but this 
is not due to any power or force that this person possesses, 
which departs from him and goes over to you, but is 
entirely due to the confidence, which stimulates your own 
nerve centers, and especially the brain. The soothing and 
quieting influence which the " Weapon Ointment" had on 
the injured person was not due to any virtue of this ointment, 
because it was never applied to the wound, but to the weapon 
or implement which caused the wound. Its operations were 
entirely mental or psychical. It pacified the excited and 
anxious mind into the faith or belief that the best possible 
thing to do was being done, and nature went on trium- 
phantly and effected the cure, for which, of course, she never 



56 HOME TREATMENT. 

got any credit. When a doctor or healer enters the cham- 
ber of the sick, putting on a wise air, or indulges in affecta- 
tion, and when he succeeds in making a good impression, that 
alone assuages the pain. But if, on the other hand, he im- 
presses his patients unfavorably, the sooner he gets out 
of their sight, the better they feel, because his presence has 
inspired neither confidence nor hope. 

Hysteria constitutes a peculiar group of diseases which 
belong to that class of nervous ailments that are included 
among functional affections; they are oftener amenable to 
faith or mind cures than to drugs. A great number of dis- 
eases of women belong to this class and these poor de- 
luded creatures never had anything real or serious the 
matter with them, until they went to some doctor who 
began to apply irritating drugs to their delicate organs, 
which made them ever afterwards habitues of doctors' offices. 

Functional diseases have a wide range. As their name 
implies, they are characterized by a disturbance of the func- 
tion of an organ or system, without any visible alteration of 
its tissue or texture; there are no pathological or histological 
changes, which the most careful microscopic examination 
can detect. They constitute a scapegoat for our ignorance; 
it appears to be in the majority of instances a disturbance 
between the psychic or spiritual forces as they operate on the 
tissues. The normal and harmonious relations between the 
mind and the body or any particular organ are disarranged. 
Such are the hysterical convulsions or spasms which we 
see in women who have suffered great mental strain, es- 
pecially grief, and often it is due to pure " cussedness," or un- 
bridled passion. In men there is also a hysteria ; it was for- 
merly believed that this peculiar nervous derangement was 
confined to women only, hence the name, but this was an 
error. I was once called to attend a physician of more than 
average ability, who located in this city for the purpose of 
enlarging his field of labor and usefulness; from where he 
came he had been very successful. His reputation as a sur- 



WHAT IS MIND CURE { 57 

geon was enviable and deservedly so, but here, in this city, 
among strangers and strange customs, he was a failure. 
This preyed on his mind so that he became despondent and 
gloomy. He failed in flesh and strength. I found him in 
his room convulsively sobbing, which shortly turned into a 
paroxysm of laughter. I prevailed upon him to return to 
his former residence among his friends and admirers, which 
he did, and he told me afterwards that from the moment he 
struck his "old stamping-ground" he felt stronger and bet- 
ter, and shortly recovered his former mirth and healthful- 
ness. 

Girls show this abnormal nervous function in different 
ways. I have known a case where a sensitive girl accidentally 
saw another girl in an epileptic fit; the contortions became 
so real and fixed in her mind, or imagination, that they were 
transmuted into motions or epileptic fits. I tried remedies 
but without any beneficial results. The parents afterwards 
went the rounds of the "fits doctors," but with the same 
negative results. A Christian scientist or faith healer cured 
her, by cultivating or strengthening her will power. 

There is a class of these faith healers, composed of silly, 
loquacious women and men, who know nothing at all of the 
principle governing their cures, and they glibly tell their 
patients, "You must say or think there is no disease, or I 
have no pain, or there is no body; all is well; all is good," 
and a great deal of similar nonsense. All is not good, and 
all is not well by any means. I would say, Indeed there is 
pain, disease, and a body, but by striving to live a healthful 
moral life, and thinking healthful thoughts, of the good, the 
pure, and the beautiful, the curative energy of nature will 
become stimulated to repair the defects, to harmonize the 
functions and dissipate disease. 

A person who is troubled with dyspepsia cannot get well 
if he thinks of nothing but an acid or sour stomach, or 
feels the food disagreeing with him before he has it in his 
mouth. He must have thoughts quite remote from these, 



58 HOME TREATMENT. 

and the chances are nine out of ten he will not feel what 
he eats. There is the same state of mind about " catching 
cold." Some persons are forever on the alert to catch a cold, 
and why should they not, when they are always watching 
out for it? If you dress so that you do not sweat, and do 
not use too thick bedcovering, and are not constantly on 
the catch or lookout, I assure you you will not catch cold, 
nor will it catch you. 

Terror or fright causes or cures diseases. Dr. Toad re- 
ports the case of a boy, in Tuke's work, nine years of age, 
who was frightened into chorea, or St. Vitus' dance, by his 
sister, who had covered herself with a white sheet and ap- 
peared before him unexpectedly, while he was in bed. I 
know, also, a case of functional bladder weakness of a child 
who wet his bed at night during sleep. There appeared no 
signs of any local disease, nor was any remedy which I em- 
ployed of the slightest advantage. The father of the child, 
becoming exasperated, gave the child a severe thrashing one 
morning. The mother remonstrated at what she considered 
cruel and useless chastisement. But, strange yet true, that 
child never wet the bed after that ; it was entirely cured by 
fright. 

Sympathy will often make persons sick; of this I had in 
my own experience an opportunity for a very interesting 
observation. It was the husband of a woman who had been 
retching and vomiting incident to the early months of her 
pregnancy. So great was the sympathy of her husband that 
he retched and vomited exactly like his wife, not only when 
in her presence, but when separated from her, the impres- 
sions or thought exciting the excito-motor nerves of the stom- 
ach. This sympathetic sickness lasted as long as that of his 
wife. 

Dr. H. C. Sawyer, author of "Nerve Waste," has kindly 
shown the writer another form of functional or hysterical 
disorder, which was, or is even yet, considered by many gen- 
eral practitioners a scrofulous enlargement of the joints; but 



WHAT IS MIND CURE? 59 

the doctor discovered the peculiarity of metastasis, which 
means a sudden or complete removal of a disease from one 
part to another. This gave the disease what he termed a 
hysterical or functional character. It would be the swelling 
of the elbow of one arm and the knee of the opposite side at 
one time; and in the course of a few weeks or months these 
would feel and appear entirely well, while the disease had 
located itself in other joints. This case the doctor consid- 
ered could be only reached through the mind, or some faith 
cure. He further believed that many of these enlarged and 
swollen joints among the wealthier classes were due to a 
nervous trouble. Indeed, it would be an easy matter to cite 
case after case, from my own experience, or quote cases from 
the highest medical authorities, illustrating in every con- 
ceivable manner how the mind, the imagination, the emo- 
tions, or the different passions, are continually causing dis- 
ease and suffering. 

It must naturally follow that what is potent to induce 
diseases will, under different conditions, be a means of curing 
them. 

A serious question now arises with reference to the selec- 
tion of cases suitable to mind-cure treatment. Bigoted 
fanaticism is quite incompetent, so are the great majority of 
spiritual healers, owing to their absolute ignorance of the 
scientific aspects of disease. The first prerequisite for intel- 
ligent and proper treatment is to establish the precise nature 
of the disease under consideration. It must be distinctly 
grouped or classed, whether it be a functional or hysterical 
disease, or a zymotic or contagious affection. 

In diphtheria or typhoid fever mind cure subserves no 
purpose; the treatment must be avowedly antiseptic and 
stimulating. 

If it be a physical injury, say a fractured bone, it must 
be treated on mechanical principles. 

A woman suffering in the pangs of labor, which is being 
delayed from some abnormal position or some other physi- 



60 HOME TREATMENT. 

cal obstruction, can only be delivered through mechanical 
methods ; and here the enthusiastic mind healer may com- 
mit serious errors, sacrificing limb and life by unnecessary 
delay. So I would lay down this broad maxim, that the 
mind healer must either be a competent, educated physician, 
or a physician should be a competent metaphysician. 

Note.— In the year 1887 Mrs. A. C. Hurrell was a healthy, middle- 
aged woman and the mother of two children. When the youngest was 
ten months old she contracted a severe cold. The coughing spells " took 
her breath," and from these exaggerated expiratory paroxysms she 
drifted into spasmodic asthma, at least that was the diagnosis of promi- 
nent medical men of Sacramento and of this city. Change of climate 
was advised and tried, so were also the different drugs which experience 
had taught to be useful, even operations were performed on her nasal 
passages by enterprising specialists, but all to no purpose. Morphine 
was prescribed by the first medical attendant, and when her suffering 
became unbearable she had to fall back on this drug for relief. In May, 
1890, 1 was consulted, but a most careful examination revealed nothing 
which I could assign as a cause and upon which to base a hopeful treat- 
ment. 

In October, 1891, she was persuaded to take treatment from a lady 
who claimed to cure through Christian Science (a mind healer). The 
treatment commenced on a Thursday afternoon. The lady impressed 
on her that the morphine, of which she now consumed, hypodermically, 
the enormous quantity of ninety grains a week, was injurious, and that 
if she made up her mind that there was no disease the asthma would 
leave her. Friday night the patient was in great agony, both from the 
withdrawal of the drug and the asthmatic attack, and this double pres- 
sure weakened the faith of both patient and healer, but the husband 
stood firm and insisted that she have no morphine. The struggle for 
breath and the narcotic continued until four o'clock Sunday morning, 
when she began to get easier; the improvement continued, and in ten 
days she had " outgrown " both. I saw her two months later, entirely 
recovered, and the most brilliant specimen of the efficiency of mind cure 
that one could wish to see. 






CHAPTER IV. 

GENERAL CAUSES OF UTERINE AND PELVIC DIS- 
EASES OF WOMEN. 

Why are womb diseases so prevalent? is a question 
which we are not infrequently called upon to answer. At 
first sight this would strike one as a casual or commonplace 
remark, but a moment's reflection makes it one of vital inter- 
est, for a truthful and intelligent reply lays bare the causes 
which undermine the health, strength and character of the 
mothers of our citizens, and when a disease of this sort be- 
comes common, it threatens the morality, health and life of 
our nation. 

The causes which operate in producing these diseases of 
the female differ widely in their origin ; some are due to ordi- 
nary imprudence, while others are deeply rooted in moral 
depravity and marital abuses and for this reason I consider 
it convenient to arrange them into three distinct classes or 
groups. 

The first class is characterized by comprising those 
causes which are for the most part accidental. They are 
peculiar to confinement and motherhood, and may be in a 
great degree controlled or averted by the skillful and compe- 
tent accoucheur. They have principally a scientific interest, 
and do not fall within the scope of the non-professional 
reader. 

The second class is entirely beyond anyone's control. 
The causes belonging to this category are innate to the hu- 
man organism; they induce those numerous afflictions 
which here and there sprout up in previously healthy per- 
sons, and are, in all probability, due to some specific hered- 

.(61.) 



62 HOME TREATMENT. 

itary taint. They are to be attributed to the natural imper- 
fections of humanity, and are a constant reminder that the 
body is simply the transient abode of the soul, or spiritual 
man, and as such only perfect in its imperfections. Like the 
causes of the first class, these, too, have principally a scientific 
interest. 

The third class of causes of uterine diseases constitutes a 
very large group, and has a popular or general interest. For 
this reason it should be freely discussed, because the causes 
of this class are avoidable. 

They are entirely within the control of the average sen- 
sible person, and for that reason should be known and under- 
stood by everyone. These causes superinduce inflammatory 
diseases, which are not confined to the womb alone but take 
in the entire pelvic appendages, the Fallopian tubes and ova- 
ries. They are the greatest source of revenue to the doctors, 
and vary in symptoms in different persons, from a slight 
casual reminder of something wrong to harassing pains and 
physical suffering; and that these all are brought about 
through ignorance, wanton carelessness, or sinful disrespect of 
nature's or God's law, is the characteristic feature of the causes 
under investigation. 

Exercise in the open air is so essential in strengthening 
the nervous and muscular systems that where this is neg- 
lected it predisposes to womb disease. I consider the differ- 
ently-devised indoor or room calisthenics or exercises as 
totally inadequate and no substitute whatever for healthful 
outdoor movement, and for the following reason: that while 
it irritates the muscular and nerve fibers, it lacks the stimu- 
lating and tonic influence of pure oxygen-laden air, so that 
the blood becomes still more deteriorated and overloaded by 
excessive waste material, which is not thrown off. If a per- 
son exercise at all with a view of deriving physical benefits, 
let it always be in the open air. Like walking, riding, rowing, 
to which bicycling should be added as one of the very best of 
outdoor exercises, the mind can then be engaged at the same 



GENERAL CAUSES. 03 

time, though it must not be overstrained. The great obstacle 
nowadays arises from a fashionable and morbid desire to culti- 
vate an appearance of delicacy; if, instead, recreations which 
required muscular exertions were more fashionable, the re- 
sults in developing strong and hardy women would be aston- 
ishing. 

No exercise can be profitable which is not interesting to 
the person who practices it. 

It is not the bodily exertion alone which can profit a per- 
son, but the hapj:>y associations, the abandonment of self 
thought, the mental relaxation, and the pleasure which ac- 
companies it. With one or two companions we can have a 
jolly time, while taking a swimming bath or floundering in 
the surf, but alone it soon becomes tiresome. If we take a 
stroll with an agreeable companion, we can walk a distance 
which, when undertaken alone, would fatigue and tire 
us completely out, while, when with an associate or friend, 
we cover the same distance refreshed and invigorated, be- 
cause the mind is entertained while the body is exer- 
cised. This must have been the experience of everyone, and 
if it teaches anything worth remembering, it teaches that 
monotonous exercises should be avoided and entertaining 
ones sought and practiced. Walks over hills in small, friendly 
groups is one of the best modes of exercise I know of. And 
then there remain the many outdoor games. The perni- 
cious systems of training which are observed in some female 
seminaries often plant the seeds for future disease. All the 
school hours are employed in reading, drawing, music, and 
other brain work, while the evenings are devoted to prepar- 
ing lessons for the following day. This is very injurious, 
and should never be permitted. 

After school hours the mind should have complete respite 
from study, so that the forces can recuperate themselves for 
the next day. 

Nervousness or neurasthenia is often a result of this ex- 
cessive mental application. Where the mind is constantly 



64 HOME TREATMENT. 

engaged in intellectual pursuits, the result often is a too 
rapid dveloprnent of the brain and nervous system. 

When the thoughts and memory of girls of tender age are 
too long and too laboriously engaged, there will be an 
abnormal development of the nervous centers; they will 
grow or develop beyond the muscular or physical strength, 
and a morbid impressibility, great feebleness of the muscular 
system, and a marked tendency to disease of the pelvic or- 
gans, is established. Parents may refer with pride to the 
precocious talents, the refined and cultivated tastes, of their 
daughters, as qualities to be admired and appreciated, but 
without a physical substratum it is a dreamy delusion. It 
would be much better for the children if their parents took 
more pride in rotund figures and robust constitutions, for these 
would ever be a source of joy, while the cultivated talents, 
especially at the expense of their health, will not only be of 
little practical value to them in after years, but often inca- 
pacitate them for wives and mothers, by making them rest- 
less, discontented, and physically unfit for maternal func- 
tions. 

There is entirely too much scholastic education imparted 
to our girls, and not enough domestic education. I be- 
lieve that the most favored should not have too much of 
one and not enough of the other, because if parents do not 
prepare girls for household duties in early life, they run des- 
perate chances of laying the foundation for a failure in the 
remote future. 

Children must be constantly reminded that they are in 
this world to serve a useful purpose, and that co-equal with 
every accomplishment is a utilitarian training. 

We take a pride if our boys trade pocketknives, espe- 
cially when our own gets the better one of the two, because 
we appreciate the natural business trait. He will be no less 
a good candidate for some of the learned professions, and, in- 
deed, it has come to this, that material success in the profes- 
sions depends as much on shrewd business tact as it does 
upon proficiency in professional attainments. 



GENERAL CAUSES. 65 

The knowledge or even wisdom of a person is of no earthly 
use to himself or the world if he or she do not possess the 
faculty of letting the people know of this superior wisdom; 
and that is why some persons often become more celebrated 
and even renowned than others, who are intellectually their 
superiors, because the former possess the faculty and cunning 
to make people believe in their superiority. By this I sim- 
ply desire to impress upon parents not to be overanxious 
about their daughters standing first in their class room, but, 
rather, to be very anxious that they attain a healthy and 
vigorous growth, and that sufficient practical knowledge of 
domestic affairs be imparted to them so that they can cred- 
itably fill their mother's places some day. This I consider 
the best legacy. 

The time to commence to train mothers is from the mo- 
ment they are born. The minds of parents should be dis- 
abused of the false delicacy about this aspect of a girl, and 
while no one expects daily lectures to be given to children 
or young girls upon the responsibilities which await them, 
such information should not be studiously avoided. I insist 
that this important fact should not be lost sight of, mother- 
hood is the ultimatum of feminine existence. 

Mistaken conceptions of woman's education, in pinning 
girls to a life of close mental application, is often produc- 
tive of uterine disease, by lowering the tone of the nervous 
system ; while others who are ambitious to acquire a profes- 
sional education in later life, fall by the wayside as hope- 
less invalids. 

I do not disparage her capacity to study with equal 
proficiency the arts and sciences, often wdth more ardor and 
closer application, than her male colleagues, but she is sim- 
ply striving to accomplish that which the men can and do 
willingly accomplish for her, wdiile at the same time she 
is neglecting the education of those qualities which are the 
sole inheritance of her sex, and which man could not usurp 
if he would. 
5 



GQ HOME TREATMENT. 

This class of uterine diseases develops in a few years into 
melancholy, which closes the windows of the soul to the sun- 
light of hope, and gradually drags the sufferer into a decline, 
that nothing but an entire change in the habits and thoughts 
of the patient will ameliorate or cure. 

I would have our girls as independent of our boys as the 
latter are of our girls. I would have it understood that each, 
in their specialty for which God and nature has ordained 
them, is as honorable and important in the social and 
industrial conditions of mankind as the other. I would give 
woman the right, and deem it her privilege, to frankly 
and unrestrainedly profess her fondness or desire to marry 
the man who she believes would make her a desirable hus- 
band, because woman's intuition transcends man's reason. 

A reform in this direction would, indeed, elevate the 
woman to man's estate, where she belongs. A little less senti- 
ment and more sense is a wholesome panacea for some of the 
abuses of the marital contract. 

I fully subscribe to the view that a woman shall at all 
times receive the same wages for her mental and physi- 
cal labor that men receive for the same work, but I am 
entirely opposed to that modern tendency and false social 
philosophy which is constantly striving to make a man out 
of a woman. There is something so grossly absurd and un- 
natural in this artificial readjustment of the natural duties 
of the sexes, in their industrial and social relations, that it 
has degenerated in many instances into fanaticism. 

Women are organizing everywhere for the purpose of in- 
creasing the facilities of their sisters in the studies of science 
and philosophy. Large sums are offered to the faculties of 
universities to gain admission to female students on an 
equal footing with the male students, for the purpose of 
studying some of the already overcrowded professions. 
In the main, all this abnormal rivalry does not contribute a 
single advantage to either sex. 

There was a time in the history of civilized nations, 



GENERAL CAUSES 07 

and that time is not more than twenty or twenty-five years 
ago, when an academical education gave an immense ad- 
vantage to its possessor over his less-informed contemporary, 
but this is not true in our time, because there is now an over- 
production of college-bred men. The man who can decline a 
Greek noun or conjugate a Latin verb is no longer a rarity, 
because the sons of European tradesmen and American farm- 
ers have deserted the pursuits of their progenitors — which, in 
the case of the American farmers, is to be deplored — and ob- 
tained a collegiate education, that is no longer the inheritance 
of the privileged few, so that in our time and day an academi- 
cal education has run to seed among the men. And now the 
-attempt is being made, under the guise of social progress, to 
burden our girls with the same wisdom that has incapacitated 
many of our boys from making an honest and independent 
living. It would be much better for the State if tw T o-thirds of 
■our universities or high schools were changed into manual 
training schools or polytechnical colleges, where the founda- 
tions for the industrial pursuits may be laid, so that labor will 
be made not only respectable but intelligent. 

We would then hear of educated mechanics or artisans, 
and scientific farmers, wdiich, to my mind, requires the same 
order of intelligence to excel, that it does in the professions 
generally qualified as "learned." 

Why crowd our girls, then, into the professions for which 
they are not only unsuited by nature, but wdiich are already 
demoralized by the keen competition within their ranks? It 
is, certainly, an open secret, in the profession to which I have 
now devoted the best years of my life, that the methods in 
vogue to get business have descended to the level of the 
41 confidence trickster," and that, no matter what ability or 
merit a person may possess, without the natural instincts and 
elements of the quack and charlatan he can gain neither a 
livelihood nor fame. This theatrical demeanor of the pro- 
fession, this aping the gaudy display of European aristocrats 
by riding in closed coaches, driven by liveried coachmen, is 



68 HOME TREATMENT. 

but the outward symptom of the internal disease of conten- 
tion for notoriety and success. 

If, instead of all this false and demoralizing philosophy,, 
termed "woman's rights" — w T hich is more appropriately 
designated ''woman's wrongs" — we turn the thoughts and 
ambitions of women towards domestic economy and domes- 
tic virtue, which alone should be and ever will be the ideal 
of noble womanhood, there will be, then, much less disease, 
more happiness, and less discontent. There is enough on 
God's earth for all of his children to eat, wear, and work, if 
the labor and the subsistence are fairly and wisely appor- 
tioned. 

The growing sentiment, which is as vicious as it is ab- 
surd, is that a girl, to be educated or accomplished, must be 
either a teacher, lawyer, or doctor, or anything else except an 
accomplished housekeeper, just as though it required less tal- 
ent or ability to raise a child, cook a wholesome or digestible 
meal, and cut or sew a garment. 

Why, there is much more thought and judgment re- 
quired in making an angel mother than in administering or 
prescribing a dose of medicine and filing a legal brief, and 
there is not a lawyer or doctor who has given sufficient, 
thought to the duties and requirements of maternity who 
disputes it for a moment. If our strong-minded women 
would preach this doctrine, which w T ould tend to make house- 
hold duties respectable, they would be benefactors instead of 
mischief makers, and then our comely girls would prefer to 
cultivate habits of domesticity, which should and w^ould be- 
come as honorable an occupation as that of a doctoress or 
lawyeress. 

Improprieties of dress are to be found in excessive or 
deficient clothing, in an improper adjustment, and in an 
inherent defect of the undergarments. I will reserve some 
of my views on these questions, for the chapter that is 
devoted to hygienic measures. In the main, the custom or 
manner of dressing women in Christian countries does not 



GENERAL CAUSES. (J!) 

deserve that sweeping denunciation that some radical dress 
reformers make. I would not, if I could, change the very 
becoming and graceful modern female dress, for it possesses 
the merit of displaying the beauties of the figure in a mod- 
estly delicate manner, and it hides its defects from the vul- 
gar gaze. 

As a rule, there is too much pressure on the abdomen, 
from the weight of heavy skirts that are suspended from the 
hips, and not sufficient room for the chest to expand, so as 
to accommodate the respirating movements of the lungs. In 
the absence of shoulder bands, to which the skirts should all 
be fastened, the much-decried corset has its redeeming qual- 
ities, for it serves the purpose of a yoke or support for the 
different undergarments, and when not tightly laced is 
rather a benefit than an injury, and if the corset had a shoul- 
der strap fastened to it over both shoulders so as to keep the 
garments from dragging on the hips, there could then be no 
objection to it whatever. The corset must always be so 
loosely worn as to permit the wearer's hands to be easily 
passed between it and the waist. It then becomes a useful 
brace to a weakly woman and entirely harmless to a strong 
or healthy one. We can imagine how a tightly-fitting corset 
will cause mischief by compressing the ribs and abdom- 
inal walls, and that this absurd fettering will prevent the 
lateral expansion of the chest, and also injuriously press upon 
the internal organs, but this is not due to an inherent prop- 
erty of the corset itself, but to an abuse of it. One might as 
well advocate a return to the Roman sandal, on the ground 
that some persons are foolish and vain enough to wear shoes 
altogether too small for their feet, thereby causing deformi- 
ties and corns. For my part, I admire a nice, w T ell-shaped, 
healthy foot, incased in a low T , broad-heeled, comfortable shoe, 
oven if its size were one or two numbers larger than a pinched- 
up, deformed one. But no one would be enthusiastic enough 
on the question of healthy feet to have us all wear sandals 
again. 



70 HOME TREATMENT. 

Warmth of the lower extremities is a very important 
point in a female's apparel, and of more importance than all 
the other questions raised on this subject. The exposures- 
endured by women, from ignorance or indifference to this 
fact, is, in my experience, a fruitful source of disease. The 
chilling blast which sweeps under the skirts must be miti- 
gated and the moist vapor arising from a damp and cold 
earth neutralized. If the limbs are only protected by thin 
cotton fabrics, they are insufficiently clad to avoid the evils 
above mentioned. It is of the greatest importance that the 
limbs of women should be incased in flannel drawers, and 
these can be worn underneath the white muslin or linen ones, 
and the hose, especially in cold or damp weather, should be 
made of woolen material; the soles of the shoes should be 
sufficiently heavy so as not to be permeable by the moisture 
from the ground, and in wet or rainy weather rubber over- 
shoes are always a necessity. When the feet and lower 
limbs are kept warm, the whole body is more or less protected 
against cold. 

Superfluous or too warm garments are the cause of an 
'endless variety of diseases. The rule is this, that any gar- 
ment which by its weight or thickness excites perspiration 
when the wearer sits quietly or exercises moderately, is either 
superfluous or too thick or heavy, and, as perspiration re- 
laxes and softens the skin, it makes one susceptible to take 
cold. It is reported on good authority that sealskin wraps 
cause more deaths among those who wear them than typhoid 
fever and for the reason above mentioned. Loosely-woven 
woolen goods make the best wraps and the best underwear. 
If we were called upon to state a single proposition which 
we considered of the greatest importance in preventing dis- 
ease, we would frankly say that, next to an irregular and 
unwholesome diet, excessive clothing is the most mischiev- 
ous factor in causing or predisposing to disease. 

The same rule applies to bedcovering ; if it be so heavy 
as to make the sleeper sweat during the night, he is al- 



GENERAL CAUSES. 71 

most sure to take cold from the sudden change, from a 
warm, moist bed to the cool room or comparatively chilled 
clothing. 

Imprudence during menstruation. A heedless disregard, 
ignorance, or carelessness of the precautions above referred to 
is, during the catamenial days, quite sure to lay the founda- 
tion for disease. Every practitioner has met with a great 
number of cases where the disease originated during men- 
struation from some indiscretion, and it ran on for years, 
until a condition of affairs was developed which was well- 
nigh incurable. 

The female organism is particularly sensitive about this 
time and much easier affected than at any other. 

During this period the ovaries and uterus are intensely 
congested, and the Fallopian tubes which connect the former 
with the latter share this condition, and if a cold should sud- 
denly check or interfere with the natural functions of these 
organs, it might result in inflammation of the ovaries or in a 
catarrh of the tubes and womb. Any one of these conditions 
is painful and often troublesome to cure, but when all these 
organs are complicated in the diseased process, which we 
frequently find to be the case, it may entail serious conse- 
quences. 

Dysmenorrhea, or painful menstruation, will be a promi- 
nent symptom, if any of the above organs have suffered from 
imprudence, during this period, and I have known of cases 
wdiich gave me no end of trouble before they were restored 
to health. 

Measurements of the healthy uterus. In a grown person 
the average length is three inches, two inches in breadth and 
an inch in thickness. It w T eighs from an ounce to an ounce 
and a half. The size of the uterus is an important guide to 
the physician in establishing the presence or absence of cer- 
tain diseases. 

In the child-bearing period measurements and weight 
change, because the organ grows correspondingly large to 
accommodate the growth of the child. 



72 HOME TREATMENT. 

Growth of the uterus from the moment of conception is 
one of the most interesting physiological studies. All its 
tissues, muscles, nerves, vessels, and lymphatics are increased 
in bulk and multiplied in number. The human ovum is 
an extremely minute microscopic cell, from one two-hundred- 
and-fortieth to one one-hundred-and-twentieth of an inch in 
diameter. This grows so rapidly that at the end of nine 
months we often have the average nine-pound baby. The 
growth of the muscular fibers of the womb is truly remark- 
able. They grow eleven times longer and twice to four times 
thicker, so that the growth of the womb keeps pace with 
that of the child. 

Changes immediately after confinement. Women as a 
rule, and their husbands also, are wofully ignorant of the con- 
dition of the womb just after confinement, and at this point 
it will be opportune to impart the necessary information illus- 
trating that it is one of the most critical periods of the entire 
process, because the pelvic organs are again very sensitive, 
somewhat akin to the menstrual condition, namely, one of 
engorgement, or congestion. 

After the child is in the world, the uterus usually con- 
tracts to about the size of a cocoanut; its measurements and 
weight as compared with what it was before pregnancy have 
materially increased. 

The diameter is now about four inches, and its weight a 
little over two pounds. If we now stop to reflect that its 
weight was formerly an ounce to an ounce and a half, to 
which size and weight it must again return, we can readily 
appreciate the important changes that must take place to ac- 
complish this object. The scientific world has only learned 
how this is effected within the last thirty years. It was a 
very important discovery. The superfluous or excessive tis- 
sues are converted into fat — the process is called fatty degener- 
ation — and as fat the tissues are absorbed into the blood and 
disposed of, and thus gradually is the superabundant sub- 
stance removed, until its measurements are as they were for- 
merly and its weight as it was before. 



GENERAL CAUSES. 16 

Involution is the name given to this process by medical 
writers. It signifies a rolling back of the size and substance 
of the womb to where it was before pregnancy. It is the 
physiological activity in the tissues of the organ to restore it 
to its former size and healthfulness. The time usually re- 
quired for nature to accomplish this remodeling varies in 
different individuals from six weeks to three months. 

Sub-involution is a term employed to designate a partial 
or complete cessation of this restorative action. The prefix 
sub means always under; in this case the same thing is meant, 
under-involution or incomplete involution. 

When, in six weeks to three months after confinement, 
the womb has not returned to its previous healthy size, 
weight and state, or if the enlargement of the womb incident 
to pregnancy lasts longer than already specified, we have the 
disease termed sub-involution. It generally becomes com- 
plicated with inflammation of either the cavity of the womb or 
of its entire substance, and often the inflammation extends 
to all the other organs and tissues in the pelvis. 

Indiscretion in getting up too soon may cause this state 
of affairs. Taking cold and excessive exertion should be 
guarded against. 

A mother who has just been delivered must gradually 
feel her way as to how much and what she may or can do 
without j eopardi zing h er recovery. Pains in the pelvis, back, 
and thighs, or a heavy, dragging sensation after getting up, 
indicate a sub-involution. These symptoms should be at- 
tended to, because the longer they last the more obstinate 
the disease becomes. 

Lying on the back after confinement for ten or twelve 
days is not only injurious but an unnecessary hardship for 
every mother. It is one of the most fruitful causes of an ab- 
normal position or falling back of the womb, and very often 
this excites diseases which greatly complicate the improper 
location of the organ. 






74 HOME TREATMENT. 

Retroversion and retroflexion of the womb will be con- 
sidered more minutely later on. It is generally caused by 
this common error of nurses and physicians, who allow the 
delivered woman to lie and often insist on her lying on the 
back. Thus the womb gradually sinks backwards, instead of 
falling forwards, where it belongs: see Plate IV. 

Women will not generally feel that anything is wrong 
until some time after they are up and around. The first few 
weeks or months after confinement, persons are inclined to 
attribute their weakness, pains in the back or thighs, and 
other disagreeable sensations, to the natural consequences of 
what they have gone through. But after weeks roll into 
months, and their former strength and health do not return, 
then they seek the advice of a doctor, who will disclose to 
them the cause of their suffering. This can be avoided 
every time by changing the positions of lying, from one side 
to the other, and from the back to the stomach for a change ; 
then naturally the womb will gradually resume its normal 
position, which is inclined forward and rests with its body 
over and on the bladder. All of these displacements should 
receive early and prompt attention. 

Antiseptic precautions. Only a few years ago this phrase 
was entirely unknown. It originated with the modern anti- 
septic treatment of wounds, and from the domain of surgery 
it has been transplanted into the department of obstetrics, in 
which the application of antiseptic principles has achieved 
the most brilliant triumphs. From this conception has 
sprung the germ theory of disease, which is now, beyond 
doubt, an established fact. 

I never can forget my first case of childbed fever. It is 
only fourteen years ago, and then there was as yet no one 
who could give a scientifically truthful interpretation of the 
disease. My patient was a young mother, who was being 
rapidly consumed by a fever, but beyond that science had 
not unlocked the causes lurking in the organism, which had 
doomed the young woman, on the threshold of motherhood, 
to a premature grave. 



GENERAL CAUSES. (0 

Thousands of lives were yearly destroyed by puerperal 
fever. Volumes of literature had been written on the subject, 
but as yet no one had deciphered its origin. 

Now the whole scene has shifted; we know that the fever 
is essentially a blood poison, a septic infection of the patient, 
precisely similar to a wound infection anywhere else on the 
body. The act of parturition causes wounds or abrasions; 
these, then, place the woman in imminent danger of infec- 
tion of every sort, and it is this infection which it is now 
possible to avoid. There is the greatest precaution necessary 
on her part and on the part of her attendants, that she be 
not contaminated by suspicious-looking finger nails, or dirty 
hands, or soiled linen, or unhealthy and unclean surround- 
ings. 

The German Government has a compulsory law for a 
system of antiseptic precautions, which is incumbent upon 
all who attend lying-in women. The importance of a rule 
to guide midwives and others in carrying out strictly anti- 
septic measures was recognized in that country some ten 
years ago, and the statistics show a remarkable diminution 
of diseases peculiar to the childbed period. The sources of 
these infectious micro-organisms are very different. They 
may be derived from the body of another person, sick or 
having died from an infectious disease, from suppurating 
wounds and even from the secretions of healthy lying-in 
patients. The patient or person herself may have improp- 
erly bathed or neglected cleanliness and ablutions, but the 
greatest danger arises from the neglected and unclean hands 
and sleeves of the midwives and physicians, and from the 
instruments usually employed under these circumstances, 
like forceps, catheters, or the nozzle of a syringe. The law 
above referred to requires all these instruments to be thor- 
oughly scalded, washed, and brushed every time they have 
been used, and by such a complete system of disinfection, 
the chances of infection are reduced to the minimum. I 
hope some day our legislators will be wise enough to give us 
similar laws. 



CHAPTER V. 

UNCLEANLINKSS AS A CAUSE OF DISEASES IN 
WOMEN. 

The custom of washing and bathing has existed from 
the earliest times. Among the Egyptians it was a part of 
their religious worship. Among the Jews it formed part of 
the ceremony of purification prescribed by Moses. The 
Greeks considered it a sanitary expedient, and among the 
Romans it was instituted for similar purposes. All virtues 
when carried to extremes degenerate into folly or vice, so 
bathing in the days of the Roman Empire, became immod- 
erate and degenerated into enervating luxury and un- 
bridled debauchery, in which indiscriminate bathing of 
both sexes was one of the demoralizing features. 

The bath was usually taken after exercise and before 
the principal meal, which rule holds good to-day, as the 
very best and proper time. The gorgeous splendor of the 
Ihermse, which was a palatial edifice constructed by Agrippa, 
was adorned with beautiful statues and fine paintings, 
while luxuriant green foliage of great variety formed en- 
chanting bowers of fairy splendor. This was thronged by 
the Roman citizens for the pleasures of gymnastic exercises 
and bathing. 

In those countries which have adopted the religion of 
the Arabian prophet, Mohammed, people bathe as a part of 
their devotions, and a religion which has for a part of its 
ritual the washing of the body, goes a great way towards 
cleansing the spirit. 

Among the Northern nations the introduction of the 
bath dates back to the period of the Crusaders, although 

(76) 



UNCLEANLINESS A CAUSE OF DISEASE. 77 

Tacitus speaks of the river bathing of the Germans, which 
was one of the strengthening methods employed by the 
early Saxons. That filth and dirt generate crime and 
moral depravity seems to be apparent, where squalid misery 
has dulled the sensitiveness to unwholesome surroundings. 

Sanitary science has also demonstrated that filth is the 
most fruitful source of diseases that are called infectious, 
because their origin is due to germs of the lowest forms of 
vegetable life. The brightest page in the medical history 
of the nineteenth century is that which records the dis- 
covery of these micro-organisms as the cause of such dis- 
eases as septicaemia or blood poisoning, pyaemia, diphtheria, 
tuberculosis or consumption and others. All forms of fer- 
mentation and putrefaction are due to the presence of some 
germs, and upon this fact antiseptic surgery bases its scien- 
tific premises. 

The germ theory of disease, like every new discovery, 
which supplants the accustomed and deeply-rooted theo- 
ries of the speculative philosophers, met with opposition, 
criticism, ridicule and misconstruction, but the brilliant 
achievements of Lister and Koch have established its found- 
ers upon a pinnacle of fame, which promises to be an im- 
mortal monument to their genius, and not only in surgery 
has its beneficial influence been exerted, but the entire field 
of medicine has been enriched by the germ theory, which 
plays so formidable a part in the causation of many diseases. 

The great boon that medical science will confer upon 
humanity, in the future, will not be so much in improved 
methods of treatment, as in the means and methods which 
medical science will devise for preventing disease. One 
ounce of prevention will always be worth a pound of cure. 
When we look back fifteen or twenty years, we must even 
now acknowledge that preventive medicine has accom- 
plished greater results than curative measures, because the 
former can be ' made in the very nature of things absolute, 
while curative agents are only relative. Puerperal, or child- 



78 HOME TREATMENT. 

bed fever, which is an infectious disease, was at times a pesti- 
lence, which destroyed women by the score, in maternity 
hospitals, or in certain neighborhoods, by the infection be- 
ing carried by midwives or accoucheurs from house to 
house, yet no one had the least suspicion that it was pos- 
sible to carry the germs of this disease under the finger- 
nails of the attendant, or on the clothing or a syringe, or on 
some other little instrument, from one patient to another, and, 
indeed, there are a great many to-day who are practicing mid- 
wifery who are still ignorant of the importance of refined 
cleanliness. 

But for this ignorance, there is no longer an excuse, be- 
cause the infectiousness of this and other diseases is so pos- 
itively established, and even the physical characteristics of 
the micro-organisms have become familiar to the micros- 
copists. This knowledge of the causation of puerperal 
fever has been applied to the employment of preventive 
measures, so that this dreadful malady is becoming a rarity, 
particularly in countries where scrupulous care and cleanli- 
ness are enforced by governmental rules and regulations. 
I refer to this particular fever, because it is, to my mind, one 
of the most brilliant illustrations of the efficacy of preventive 
or antiseptic medicine. 

There is a gynecological hygiene with which women 
should become familiar ; it is based on the principle of anti- 
septic precautions applied to the daily lives of their sex. 
The object of this is to keep the body and reproductive or- 
gans that are exposed to contamination or infection from 
the outer world in the most refined and scrupulous cleanli- 
ness. The vaginal douche or syringe is as important an 
auxiliary to a refined woman's toilet case as her tooth 
brush, because the cleanliness of the genitals is as essential 
to the preservation of health and comfort, as the possession 
of a sweet breath and the preservation of the teeth. I am 
therefore convinced of the hygienic value of familiariz- 
ing little children with washing or sponging their external 



UNCLEANLINESS A CAUSE OF DISEA3E. 79 

genitals; in a few years this will have become second nature, 
and they are thus protected for all future time from con- 
tracting diseases which have their origin in personal un- 
cleanness. It behooves mothers to avoid all delicacy on 
this subject, so that their little ones may grow up with the 
sentiment that to the pure in heart all things are pure. 
It is false modesty and ignorance which degenerate into 
vice and excesses; the scientific truth is always pure and 
holy, because it is based on reason, while abnormal delicacy 
is only emotional, and is quite likely to shoot into the other 
extreme, namely, licentiousness. 

As the world grows wiser, the physiology of the reproduc- 
tive organs should form a part of its wisdom, and in pro- 
portion to this knowledge, will their functions become ques- 
tions of sense, instead of sentiment and nonsense. 

The vagina is a membranous canal. It is situated in the 
cavity of the pelvis, below and behind the bladder, and in 
front and above the rectum. Its direction is curved from 
before backwards and a little upwards; its walls are flattened 
and ordinarily in contact with each other. Its length is 
about four inches along its anterior wall, and an inch or two 
longer along its posterior wall. In introducing a nozzle of 
a syringe it must always be remembered, that the tube is to 
be introduced directly backward on a horizontal plane with 
the body in the erect posture; by attempting to introduce it 
directly upwards, you meet with resistance from the anterior 
wall of the vagina. 

In this cavity the secretion is susceptible of decomposi- 
tion, owing to the accessibility of air laden with germs, 
which excite fermentation. A day or two after the cessation 
of the menstrual flow, there still lingers a little blood in the 
cavity of the vagina ; this becoming infected with the germs 
in the vagina, a decomposition is the result, which is recog- 
nized by an offensive smell. The naturally soothing and 
harmless secretion is now changed into an acrid, irritating 
fluid, which not only may cause an inflammation of the 



80 HOME TREATMENT. 

membrane of the vagina, but also excoriate the skin at the 
orifice of the canal. 

Leucorrhcea, or what is commonly called ivhites, is the 
most distressing symptom of this condition. In the course 
of months or in some instances a few years, the inflamma- 
tion spreads from the vagina to the mouth and lining mem- 
brane of the uterus. Inflammation of the endometrium or 
lining of the womb will excite another complication, the so- 
called ulceration, but more correctly termed erosion. Who 
will deny the usefulness of any advice that will teach girls 
or women to avoid all these diseases? It is all contained in 
the simple phrase, Keep clean. Young girls must be taught by 
their mothers or guardians, not only the necessity of keeping 
the external genitals clean by daily ablutions, but a few 
days after menstruation, upon the slightest indication of 
offensiveness, she must resort to the employment of the vag- 
inal douche or syringe, so as to wash out the seeds of dis- 
ease, that are rapidly multiplying themselves, and if al- 
lowed to remain will entail the consequences to which I 
have already referred. 

As an antiseptic wash, there is nothing so simple, effica- 
cious and healing, as a solution of borax in previously 
boiled water, that has been allowed to cool to the proper 
temperature, which is between 103 and 106 degrees Fahr., 
one teaspoonful of the powdered article to the half gallon 
of water, to be used as a rinsing for each time. 

Directions for administering vaginal douches will be 
given elsewhere. The proper time of the day for the em- 
ployment of the wash is always at bedtime; and once or 
twice a week is quite often enough in the majority of in- 
stances. 

Married women are more exposed to infectious contam- 
ination than single ones, because they are constantly liable 
to have infectious microbes introduced into the vagina dur- 
ing the ordinary course of marital relations. Men, as a 
rule, are neither cleanly nor careful in their habits, and 



UNCLEANLINESS A CAUSE OF DISEASE. 81 

approach their wives without any thought of serious con- 
sequences in their sexual relations. I had a married 
woman under treatment for an offensive discharge from 
her vagina which I traced to her husband, thence to a sup- 
purating wound on his horse, which the husband had under 
his treatment. This can happen, of course, only through 
carelessness. By getting some of the matter or pus on the 
fingers, which incidentally contaminates his person, or not 
washing and brushing the finger nails, the husband may 
directly convey the infection to his wife, and thus inaugurate, 
unconsciously, an inflammation of the vagina, which becomes 
complicated, as the primary disease is neglected, leading to 
inflammation of the womb and ovaries, and often to ab- 
scesses, that compromise not only the health but the life of 
the sufferer. 

To preclude the possibility of innocent infection, between 
husband and wife, there is only one means of prevention, 
and that is a careful toilet, which thoroughly cleanses the 
bodies in general and the genitals in particular. 

Another fruitful source of disease of women, in this coun- 
try and to an alarming extent in Europe, to which the elder 
Martin of Berlin called the attention of the profession over 
thirty years ago, is the specific or gonorrhceal infection of 
wives by their unfaithful husbands. The number of poor 
women whose health has been irretrievably ruined, by their 
husbands having had illicit relations with lewd, diseased 
women, is only known to those who have made this class of 
diseases a special obj ect of inquiry. I have nothing to do with 
the moral aspect of this question, but only with the physical 
suffering that such men inflict upon their innocent wives 
and the. mothers of their children, for the brief indulgence 
of libidinous pleasure. To think that any man would take 
the chances of making his wife a suffering and perhaps in- 
curable invalid, just for the purpose of gratifying temporary 
animal passions, is to place him beneath the brute creation, 
which has not the intelligence to reason on the fearful con- 
6 



82 HOME TREATMENT. 

sequences. No man who has been guilty of illicit relations 
should return to his wife until seven days have elapsed, and 
even not then until he has repeatedly washed himself by 
means of a syringe with some cleansing or disinfecting fluid, 
like borax water, or, what is preferable, a weak solution of 
the bichloride of mercury. 

The wife and mother who entertains the slightest sus- 
picion, must insist upon these precautions, and then not 
neglect to thoroughly wash and cleanse herself in the man- 
ner previously referred to. It is the height of hypocrisy 
to be mealy mouthed on this subject; the wives and moth-' 
ers who are fortunate to have husbands beyond suspicion, 
should learn that some of their sisters have dangers to en- 
counter and heartaches to suffer, with which their own lives 
are not marred, but perhaps the lives of their daughters may 
be ; for the unhappy woman who becomes the wife of the 
blear-e} T ed sensualist, there is only one relief, and that is edu- 
cation in these subjects. 

I know of no disease in which a correct and early diag- 
nosis or recognition is of greater importance to avoid the 
frightful consequence and serious complications, than this 
one. It begins with a mild vaginal catarrh, which, when it 
is as yet locally confined to the vagina, can be easily cured. 
In course of time it spreads itself along the vaginal tract to 
the cavity of the womb. When it gets there, the treat- 
ment becomes more complicated, and for this reason ; in or- 
der to reach the disease now, the cavity of the womb must 
be dilated, and this is an operation which the average 
physician can only accomplish in a bungling and imperfect 
manner. But even in this stage of the disease, in the hands 
of a skillful physician, the course of the disease can be 
checked and the patient readily cured. When the disease 
gets beyond the womb, when it invades the Fallopian tubes 
and the ovaries, the picture has entirely changed. 

The organs affected are then inaccessible to local treat- 
ment, so that the disease invariably continues until the or- 



UNCLEANLINESS A CAUSE OF DISEASE. 83 

gans are more or less destroyed by inflammation, which 
results in the tissues breaking down into an abscess. In 
this stage of the disease it has become quite the fashion to 
operate in this class of cases, offering as an excuse a sure 
and speedy cure. Here I would interpose a word of warn- 
ing to sufferers belonging to this class, not to be too willing 
to comply with surgical methods, because I know from care- 
ful observations, that promises of this nature end often 
in disappointment and death, while an intelligent conserv- 
ative treatment can only disappoint but never kill, and with 
patience and perseverance in the application of electricity 
and hygienic rules of health, a cure is almost certain. The 
sick in body and mind are often beguiled into operations of 
a very serious nature, which are entirely unnecessary, be- 
cause better results can be accomplished by other methods 
•of cure, in which the possibility of a fatal termination is 
excluded. 

Some women feel tired and languid from morning until 
night.; they feel as tired in the morning when they get up 
as they were in the evening when they retired. If we 
tell them that it is entirely due to negligence of their own 
persons in not using vaginal washings regularly, they will 
undoubtedly feel surprised. In the great majority of these 
■cases, this is owing to putrefactive changes going on in the 
cavity of the vagina. In the process of fermentative decom- 
position, the so-called ptomaines are developed; these are 
chemical poisons, which are absorbed into the blood, and 
by their depressing influences on the nervous system are 
the cause of the weakness and tired feeling. There are no 
remedies which, when taken into the stomach, will do the 
slightest good for this condition, and it is a waste of both 
time and money to expect relief from drugs. 

This can easily be remedied by cleanliness, so that the 
secretions are not long enough retained in the vagina, to 
■decompose and develop these ptomaine poisons. 

During and after confinement is another important time 



84 HOME TREATMENT. 

for the employment of vaginal washes. The lochial discharge, 
which is one of the ordinary accompaniments of the newly- 
delivered woman, is a discharge from the uterus, which con- 
tinues for several days, growing less and less, for a few 
weeks, when, in a normally healthy state of affairs, it should 
cease entirely. The lochia is the oozing from the mouths 
of the blood-vessels of the womb where the placenta or after- 
birth was attached, together with the passing off of the old 
lining membrane of the womb, while the organ is returning 
to its original condition. At first the discharge is bloody, 
and it may retain this character for two or more days after 
delivery; then the color is changed, partaking more or less 
of a watery nature and presenting a yellowish hue ; it then be- 
comes whitish and ultimately ceases altogether. After the 
first four or five days the lochial discharge often becomes very 
offensive; this is a sign of putrescence or decomposition, and 
the only remedy in this, as in all other similar instances, is 
to wash the vagina thoroughly with borax water, or with a 
preparation for which a prescription will be given further 
on. 

In every case of delivery, the mouth of the womb is more 
or less torn or lacerated; this is unavoidable, and it is gener- 
ally harmless. One of the surgical humbugs is to sew or stitch,, 
or attempt to stitch, these little harmless tears together, not 
of course for the good it will do the patient, because she is 
more likely to be injured by this meddlesome surgery, but 
to make a business and a fee. The common practice of these 
and kindred surgical expedients is one of the crying evils of 
an overcrowded profession which is trying to keep itself em- 
ployed at all hazards. 

The vagina also receives more or less injury during an 
ordinary confinement ; if the midwife or the doctor is too 
meddlesome or in too big a hurry to get through, he will 
use the forceps, which simply means, to pull the child out 
and through the vagina, before nature has had time to 
dilate or stretch the parts sufficiently, to allow the child 



UNCLEANLINESS A CAUSE OF DISEASE. 85 

to pass through the maternal organs without injuring them. 
As a result of this brutal haste, frightful lacerations are in- 
curred, which require immediate attention, but small lacer- 
ations heal without any further treatment than to keep clean. 

After every confinement there is considerable sore or 
raw surface, with which the offensive discharge comes in 
contact, to become readily absorbed or taken up into the 
system, giving rise to fevers or inflammations of the womb 
and other pelvic organs. If one has a wound on any part 
of the body, the first thought would, or rather should, be to 
keep it clean ; exactly the same treatment is required for 
wounds of the womb and vagina. 

When the discharge becomes offensive, it also becomes 
dangerous and poisonous, and the only and proper thing to 
do is to thoroughly wash out the entire vaginal cavity until 
all offensive smell has disappeared. The only sure sign 
that anyone can have of the completeness and thorough- 
ness of the vaginal washings, is that there is no longer any 
fetid or offensive smell perceptible. 

It requires no particularly trained nurse or expert to 
administer a cleansing vaginal injection, yet it is more 
likely to be done in a bungling, inefficient manner than in 
a proper workmanlike manner; for this reason, it would 
be well to remember a few of the necessary details of carrying 
out the douching. In the first place, the room in which 
the vaginal douche is administered must be comfortably 
warm, so as to preclude the possibility of chilling the 
patient ; the windows or any other opening liable to cause 
draft must be closed. The nozzle of the syringe, whether it 
be a fountain or a family syringe, must have been thor- 
oughly brushed and cleansed with soap water, before and 
after each use ; if the instrument is old, or has been used for 
questionable purposes, or, perchance, made the rounds of the 
neighborhood, it had better be thrown into the ash barrel, and 
an. entirely new syringe, the "Alpha," be employed, which, 
by its sure and continuous stream, I consider the most suit- 



86 HOME TREATMENT. 

able female syringe. The bulb of a syringe must be com- 
pressed in the palm of the hand slowly and deliberately. 

The position of the patient is of considerable importance; 
a vessel is placed under her, which is carefully adjusted, 
so as not to tip too far backwards, otherwise it will overflow 
and drench the bed or the patient's clothing. Beneath the 
small of her back a few extra pillows are placed, and thus 
she comfortably reclines on her back, while the attendant 
manages the disinfecting wash and syringe, placed in a 
basin between her thighs. Half a gallon of the fluid is 
usually sufficient. The temperature of the wash is very im- 
portant and may range between 103 and 106 degrees Fah- 
renheit. 

The recumbent position is only intended for women 
who are confined to their beds ; others, who are around and 
about on their feet, can sit comfortably over a chamber, on 
the edge of a low chair, having the vessel underneath them, 
and the wash of course in a separate basin. In the course 
of my experience I have been called to mothers, five to eight 
days after delivery, who were in a raging fever, presumably 
from the ptomaines which had developed in the vagina and 
poisoned the blood. After a few vaginal injections, some- 
times after the first, the fever subsided entirely. These re- 
markable results we owe to the antiseptic treatment of dis- 
ease, and when it once becomes generally known that this 
is only another word for cleanliness, infectious diseases will 
grow correspondingly less, and the cure for those that exist 
will be less experimental and more reliable. 



CHAPTER VI. 

MARITAL EXCESSES AND PREVENTION OF 
CONCEPTION. 

In a previous chapter, the physiology of conception was 
explained, and it was shown to be an organic function, in- 
dependent of and remote from the sexual act, and over which 
the parties to the act have no control. From this scientific 
statement of the actual fact, it becomes at once apparent that 
conception or pregnancy may result without natural sexual 
congress, by simply injecting the sperm of the male, by 
means of a uterine syringe, into the womb of the female, 
while she is in a state of unconsciousness. It is also quite 
probable that a criminal conspiracy of this nature could 
be carried out, without any violation to the delicate anat- 
omy that is involved in the natural process; a detailed 
account of all the probabilities which the ingenuity of a 
scientifically-trained mind could devise, belongs more prop- 
erly to the department of medical jurisprudence. It is, how- 
ever, of sufficient general importance that the reader should 
have at least an idea of the door that has been unlocked 
through physiological researches. 

What we are at present endeavoring to make clear is, 
the great distinction and difference between coition and fe- 
cundation or conception; while one is but the result of the 
natural instinct aroused by the senses, the other reaches out 
into the realm of the Creator. When man undertakes to 
destroy the product of conception, he has interfered with 
the prerogative of God and is guilty of murder. 

The question may now naturally arise in the minds of 
pure and morally-disposed persons, whether there is any 

(87) 



88 HOME TREATMENT. 

time, without doing violence to God's law, that the children 
of men have the moral right to control, or regulate, the' pro- 
creation of the human race? If I answer the question in 
the affirmative, I will then proceed to inquire into the ways 
and means to that end, and also into the pernicious methods 
that are employed, to accomplish this result. 

It is true, that the Divine command was to be fruitful 
and multiply, but before this command was given, man was 
a free agent and a reasoning being, which implies that he is 
after all to be the judge as to the degree in which this com- 
mand is to be carried out. That is, that there are mitigating 
and qualifying circumstances, which man has not only a 
right to consider, but which he is expected to take into 
account in propagating the species, by virtue of his reason- 
ing faculties. 

If this command were absolute and universal, chaste 
celibacy would be a cardinal sin, yet it has always been held 
by the canons of spiritual growth and morality, to be a Di- 
vine virtue, and even the loving Jesus knew not woman, be- 
cause the forces that are thus expended will exert their 
power in other directions and towards developing powers of 
a higher order. 

I believe that a moral code, which is too exacting to be 
observed by the average person, fails to accomplish the re- 
straint or reform that is desired, so that, after all, it becomes 
essential to lay down such rules as the average men or 
women can follow as guides for their actions. A reformer, 
who starts out with the broad declaration that it is im- 
moral to take human life, and a murderous act to destroy a 
half-formed human being in its mother's womb, and that it 
is equally murderous to prevent the recent products of the 
sexual act from becoming a viable being, fails to make the 
impression he desires. The first half of the proposition neu- 
tralizes the second of its sacred essence, in placing on the 
same level the organic function of conception and the ani- 
mal function of the sexual act. 



PREVENTION OF CONCEPTION. 89 

This view is so manifestly absurd to the person of even 
ordinary perception, that I feel assured, that it would neither 
lessen feticide nor sexual excess. 

Spermatozoa on the one hand, and the ova of the female 
on the other, are, even in the natural and uninterrupted 
course of nature, destined for destruction, for whenever the 
female menstruates, these ova are discharged, and whenever 
the male copulates, hundreds of spermatozoa are found 
swimming in the spermatic fluid, which in case there be no 
ripened ovum are nothing more than so much waste secre- 
tion. Both are a means to an end, and that end is the 
reproduction of the species. It appears to me a flight of 
fancy, from the sublime to the ridiculous, to assign to the 
sexual act the same importance as to the passive function of 
conception, and I believe that doctrines of this nature lack 
not only the least scientific support, but weaken any argu- 
ment in favor of the moral or spiritual aspect, which alone 
raises the question of feticide from a social evil to a mortal 
sin. 

Man is prompted by a powerful instinctive desire for the 
use of the sexual organs, that draws him involuntarily to 
the opposite sex, not for the continuance of the race, be- 
cause the passion arises much oftener without the remotest 
thoughts of any fruitful results. I have the greatest regard 
for the life of the unborn child, yet I am far from agreeing 
with those who would stamp as libidinous every thought of 
the sexual instinct, that has not as its stimulus the pro- 
creation of the species. While the average man is in the 
flesh, he is an animal man, and there is no use of trying to 
„ make a spiritual saint out of flesh and blood, and when we 
do find that, we have a very exceptional and remarkable 
person. But what, as reasonable beings, we should do, is to 
bridle the animal passions with moral reins, so that we can 
stand up, in full-statured manhood, with the respectful ap- 
proval of our own conscience, able to rise above the mere 
animal appetites, to the dignity of reasonable beings. This 



90 HOME TREATMENT. 

instinct, like other propensities, is excited by sensations, and 
these may originate either in the sexual organs themselves, 
or may be excited through the organs of special sense. In 
man the passion is most powerfully aroused by impressions 
conveyed through the sight or the touch. It often happens 
that localized sensations will excite the sexual desire of either 
sex, so that many cases of excessive sexual desire can be 
traced to some local disease of the genital apparatus : chief 
among the numerous causes that may be cited, is pruritus or 
local itch, erythema and active congestion of the womb and 
ovaries. 

"This tendency cannot be regarded," says Dr. Carpen- 
ter, "as a simple passion or emotion, since it is the result of 
the combined operations of the reason, the imagination, and 
the moral feelings : it is in this engraftment of the physical 
or spiritual attachment upon the more corporeal instinct, 
that a difference exists between the sexual relations of man 
and those of the lower animals. In proportion as the human 
being makes the temporary gratification of the mere sexual 
appetites his chief object, and overlooks the happiness aris- 
ing from spiritual communion, which is not only purer but 
more permanent, and of which a renewal may be anticipated 
in another world, — does he degrade himself to a level with 
the brutes that perish. Yet how lamentably frequent is this 
degradation." This quotation gives the entire physical and 
spiritual aspect of the question, by one of the most eminent 
physiologists of our time, so that in the natural course of our 
investigation we are led to inquire into the currents of 
thought, which would tend towards developing moral re- 
straint. 

Moral restraint means the restraint of the animal man by 
his spiritual or higher self; the will must possess its due pre- 
dominance to exercise its determining power in curbing the 
passions of the one, and directing the course of the thought 
in the other. 

The cold, calculating materialist, whose ideal is circum- 



PREVENTION OF CONCEPTION. 91 

scribed by the laws that have been deduced from the phe- 
nomena of the material world, can scarcely appreciate the 
higher sentiments that are involved in this investigation, 
unless he becomes changed in thought and feeling to the 
things that are about him. To accomplish this result is 
hardly within the scope of this work. With the average 
man as we find him, my observation has taught me that it 
makes, after all, little difference, whether he believes in a 
spiritual nature or is avowedly materialistic. The great 
majority of men and women live, so to say, in the turbulent 
waters of their own passions, wafted hither and thither by 
the impulses of emotional excitement and instinctive desires. 
There is little or no hope for reform, if they have not 
sufficient force of character to cry halt, and stop to think 
a little upon questions which are to them of the greatest 
importance. 

Marital excesses are the mainspring of so much disease, 
that ordinarily is attributed to quite different causes, that 
this chapter would be very deficient were I to omit to call 
the attention of my readers to this fact. The men on the 
whole are oftener the victims of the ill effects of unbridled 
lust than the women, which shows itself by violent and un- 
controllable temper, in the one case, and stupid docility in 
the other: by a lean, hungry, nervous appearance, or a brut- 
ish, sanguineous obesity; extremes of the different tempera- 
ments and habits are but the natural outgrowth of the con- 
stitution inherent in each individual case. 

Women, as a rule, are more passive, less amorous and 
more chaste in thought and feeling than men, and if we 
define emotion as an idea associated with pleasurable or 
painful feelings, women are, as far as appertains to their 
sexual nature, contrary to the generally-accepted opinion, 
much less emotional than men. Continence, among the 
unmarried women, is the rule, while among the men it is 
the rare exception; this is because her will is by nature 
stronger, while her reason is weaker, she intuitively arrives 
at conclusions that are her guide and saviour. 



92 HOME TREATMENT. 

It is a prevalent idea among men that the marriage cere- 
mony removes all restraint from the exercise of the sexual 
function ; this not only neutralizes and destroys all sentiment 
of true love, which seeks for the happiness of the object it 
loves, but breeds hatred and contempt. To be permanently 
happy and mutually respectful, there must be love beyond 
the pleasure of gratifying the mere sexual instinct, there 
must be love in the realm of thought and a spiritual com- 
munion above the instincts of the flesh. 

"Any warning against sexual dangers," says Dr. Acton, 
"would be very incomplete if it did not extend to the ex- 
cesses so often committed by married persons in ignorance 
of their ill effects. Too frequent emissions of the seminal 
fluid, and too frequent excitement of the nervous system, are 
in themselves most destructive. The result is the same 
within the marriage bond as without it. The married man 
and woman who think that because they are married, they 
can commit no excesses, however often the act of sexual con- 
gress is repeated, will suffer as certainly and as seriously as 
the unmarried debauchee, who acts on the same principle in 
his indulgences — perhaps more certainly, from their very 
ignorance, and from their not taking those precautions and 
following those rules which a career of vice is apt to teach 
the sensualist. Many a man has, until his marriage, lived a 
most continent life; so has his wife. As soon as they are 
wedded, intercourse is indulged in night after night, neither 
party having an idea that these repeated sexual acts are ex- 
cesses which the system of neither can bear, and which to 
the man, at least, is absolute ruin and to the woman a source 
of disease. The practice is continued till health is impaired, 
sometimes permanently, and when a patient is at last obliged 
to seek medical advice, he is thunderstruck at learning that 
his sufferings arise from excesses unwittingly committed. 
Married people appear to think that connection may be re- 
peated as regularly and almost as often as their meals. Till 
they are told of their danger, the idea never enters their 









PREVENTION OF CONCEPTION. 93 

heads that they are guilty of great and almost criminal ex- 
cess; nor is this to be wondered at, since the possibility of 
such a cause of disease is seldom hinted at by the medical 
man they consult. Some go so far as to believe that in- 
dulgence may increase these powers, just as gymnastic ex- 
ercises augment the force of the muscles. This is a popular 
error, and requires correction. Such patients should bo 
told that the shock to the system, each time connection is 
indulged in, is very powerful, and that the expenditure of 
seminal fluid must be particularly injurious to organs pre- 
viously debilitated. It is by this and similar excesses that 
premature old age and complaints of the generative organs 
are brought on." 

Wives of men of great vital force are not long before 
they become delicate, sickly and nervous, and, entirely igno- 
rant of the real cause of their feebleness, seek relief by tak- 
ing "a good iron tonic," which does them about as much 
good as if they had left it alone, the tonic effect of iron 
being entirely overestimated, but the delusion is created by 
associating the word iron with the idea strength. After the 
different tonics have been tried, the patient consults a phy- 
sician, who, on general principles and after a hasty exam- 
ination, informs her that she has " womb disease." These two 
words for the time being settle the question ; she now be- 
gins "to doctor," and from the general or family doctor she 
finds her way to the female specialists, who, as a rule, be- 
long to the recognized magnifiers and humbugs of the day. 
Here she becomes one of the regular habitues of the special- 
ist's waiting room, disappointed and not a little discouraged. 
She makes the rounds of the most prominent of them, until 
she has been doctored out of her dear patience and her still 
dearer money. Hope is often a forlorn consolation, and if 
by chance she now takes a trip to the country or undertakes 
a long visit at some distance, to her folks, which gives the 
poor woman respite from the "marital rights" of her Lord 
and Master, she recovers her former health, strength and 



94 HOME TREATMENT. 

buoyancy. Of course everybody congratulates her upon 
the wonderful effect of the climate, when the climate had no 
more to do with her recovery than the moon. The re- 
markable change was owing to having been let alone by 
husband and doctor. 

That the attempt to call attention to these flagrant abuses 
of the dishonesty and ignorance of the one and the blind 
animal instinct of the other will be decried and stigmatized as 
" cranky," I know beforehand, but I know also, that those who 
criticise these sentiments are fully convinced of the truth 
of the statement. The diseases that belong to this class 
are, like most uterine diseases, of an inflammatory nature, 
and for that reason rest is one of the most essential features 
in the treatment. But as this class belongs to the avoid- 
able causes, prevention is much better than cure. I there- 
fore advise, as of first importance, to abandon the American 
custom of man and wife occupying the same bed, which is 
only customary among the poorer classes of Europe, who can- 
not afford to have separate beds or chambers. The advan- 
tage of the European custom in segregating one's self on 
retirement, to avoid the sexual instincts being unduly ex- 
cited, can be borne out by remembering the physiology of the 
instinct, which we were told is excited by sight and feeling. 
Besides these, there is the possible undue familiarity, which 
the joint occupancy of the chamber or bed of man and wife 
may engender, and that, too, is likely to lead to excessive re- 
lations. 

All efforts to exercise voluntary control, by prolonging 
the sexual act or extending the venereal orgasm, are fraught 
with the most pernicious results to the nerves, termina- 
ting in a partial or complete paralysis of the different or- 
gans of the body, or a low grade of inflammation is excited, 
which offers a fruitful soil for the development of various 
diseases. 

A man who has become the husband of a woman should 
never cease to be a gentleman on that account, nor should 









PREVENTION OF CONCEPTION. 95 

he become lost to a consideration of those delicacies of re- 
finement, which smooth the common relations in the exer- 
cise of daily duties. 

Continence is the complete restraint from sexual indul- 
gence, which in its fullest sense does not apply to the 
married state, but it comes within the scope of every mar- 
ried life to cultivate and practice it as one of its virtues. 
Every married couple should be continent for days and 
weeks at a time, and when one or the other is not feeling 
well, abstinence should be practiced, as the rule, not only to 
avoid a nervous shock, which may have serious results, but 
because conception in an abnormal physical condition, will 
perpetuate itself in the child, which is quite likely to inherit 
a nervous or sickly constitution. When pregnancy super- 
venes, undue sexual excitement of the mother often has the 
most serious consequences to the fetus, and may result in 
its death, or induce abortion. 

Diet is to be regulated, to assist a firm determination 
to lead a chaste and purer life. Stimulating and highly- 
seasoned food, and alcoholic beverages, are not to be used, be- 
cause they increase the circulation of the blood and stimu- 
late the nerves to inflammatory activity. Meat should be 
eaten only once a day, and the supper should be bland and 
light. 

Nature has set a time during which continence should be 
practiced for the purpose of preserving the health and con- 
trolling the reproductive function, that is, the menstrual 
period. Menstruation in women corresponds to the ripen- 
ing and discharge of the human ovule. The aptitude for 
impregnation is a day or two before and six to eight days 
after the courses cease. This is a rule which applies to the 
great majority of women, and if the sexual relations are sus- 
pended from a few days before the onset of the menses until 
six or eight days after the flow has ceased, the chances for 
pregnancy are reduced to the minimum. This physio- 
logical relation of the organic function of conception to 



96 HOME TREATMENT. 

the sexual act is to be recommended as the most wholesome 
check to reproduction in early married life, although I be- 
lieve that there is no time better calculated to raise a family 
than while you are young and hopeful. 

Children are common objects of love and hope for both 
parents. Life and health are ever changing the relations of 
our surroundings, and when newly-married people put off 
to the dim future the hopes of rearing a family, they are 
often doomed to everlasting disappointment. Nature is ca- 
pricious and jealous of her prerogatives, and those who trifle 
with her functions must expect to be frustrated in the end, 
and have no one but themselves to blame if she fails to re- 
spond to their capricious wishes. Children make trouble of 
course, so were we as troublesome in our time, but there is 
also a great deal of pleasure in watching them grow from 
day to day in bodily strength and mental perception, which 
no amount of selfish enjoyment can compensate. 

The diseases that are brought upon women by the differ- 
ent practices and mechanical devices to prevent conception 
are too numerous to mention in a work of this character.- 
Some of the methods are absolutely loathesome to all sense 
of decenc}^ and reduce sexual intercourse much below the 
instinctive indulgence of the brute; these debauches of the 
conjugal bed not only sap the vitality of the participants, 
but must lower or destroy all mutual respect, and ultimate 
in dissension and strife, which the divorce court will finally 
assuage. 

Referring to the practice of conjugal onanism or inter- 
rupted or incomplete coitus, Dr. Franklin Devay says: 
" However, it is not difficult to conceive the degree of per- 
turbation that a like practice should exert upon the genital 
system of woman by provoking desires which are not gratified ; 
a profound stimulation is felt through the entire apparatus; 
the uterus, Fallopian tubes and ovaries enter into a state of 
orgasm, a storm which is not appeased by the natural crisis; a 
nervous super-excitation persists. There occurs, then, what 



PREVENTION OF CONCEPTION. 97 

would take place if, presenting food to a famished man, one 
should snatch it from his mouth after having thus violently 
excited his appetite. The sensibilities of the womb and the 
entire reproductive system are teased for no purpose. It is 
to this cause, too often repeated, that we should attribute the 
multiple neuroses, those strange affections which originate in 
the genital system of women. Our conviction respecting 
them is based upon a great number of observations. Fur- 
thermore, the normal relations existing between the married 
couple undergo unfortunate changes; this affection, formed 
upon reciprocal esteem, is little by little effaced by the repeti- 
tion of an act which pollutes the marriage bed; from thence 
proceed certain hard feelings, certain deep impressions, which, 
gradually growing, eventuate in the scandalous ruptures of 
which the community rarely know the real motive." This 
is in every respect as hurtful as the vicious practice of 
solitary vice, although that is comparatively less common 
among young virgins than among those of the opposite sex. 
Nevertheless, this is a frequent cause of hysterical symptoms 
and uterine disease. Stop it at once; there is no burden that 
a large family of children can impose upon you, be it even 
poverty and want, as great as the inevitable results of these 
unnatural habits. 

The use of caps or tissue coverings, made of thin rubber 
or gold-beater's skin, are not only suggestive of the licentious- 
ness of the brothel but their employment causes physical le- 
sions from their irritating friction to the walls of the vagina. 
I have had under my treatment obstinate ulcerations of the 
vagina which were due to their use, and in one instance it 
degenerated into cancer. The use of the "womb veil," which 
originated in France, has been denounced as a fruitful source 
of ulceration of the womb, by modern French writers, who 
are more familiar with their indiscriminate employment 
than Americans. There has been also a plug or stem pes- 
sary employed for the purpose "of sealing up the womb," 
which is partly introduced into the mouth and cervical canal 
7 



98 Home treatment.. 

of the organ; this obviously adds insult to injury, by also 
irritating the cavity of the womb and exciting inflamma- 
tion of its lining membrane. There are other devices for 
a similar purpose, that have the same tendency of irritating 
and wounding the genitals of the female. 

There is nothing that could be said, to intimidate some 
women, by forewarning them of the danger of their preven- 
tive measures; they will continue to make business for the 
specialists, and drain the purses of their husbands, but there 
is a great majority of good, noble, matronly women who are 
pure in heart and mind, that appreciate the value of the in- 
formation that I impart. What I desire to further suggest, 
is a preventive measure that is entirely harmless and con- 
sistent with chastity and cleanliness, for I believe that within 
certain bounds, a woman has a moral right to limit or con- 
trol the conception of her womb. But right here the option 
ceases. If she pushes her measures beyond the portals of 
the womb, if she employs medicines or mechanical devices 
to bring around her courses, when she suspects pregnancy 
or conception, she becomes a murderess in the eyes of the 
Creator. The bowl of tanzy tea, or any of the many quack 
nostrums, advertised in the public prints, are as much an 
instrument of murder as the probe of the abortionist. It would 
be the height of sophistry to make a distinction between the 
embryo of an hour or a day old, and that of any future 
period. The potentiality of a human being is established 
at the moment of conception, and the destruction of this, at 
any period, is homicide. No one can deny less importance 
to the cause, which is conception, than to the effect, which is 
the human embryo, for without the one, the other is impos- 
sible. 

Hence, not to bear a child implies not to conceive a 
child, for if once conceived, it must be born. 

The reasons that may exist for limiting the progeny of 
each particular pair cannot be formulated into a code, for 
these are questions of conscience, between the individuals and 



PREVENTION OF CONCEPTION. 99 

their Creator, on the one hand, and on the other, they should 
be influenced by economic conditions and physical or con- 
stitutional taints of the progenitors. I do not believe in the 
truth of the law of Malthus, that there is a tendency for 
population to increase faster than the means of subsistence, 
but I am inclined to the view held by John Stuart Mill, that 
•"no one has a right to bring children into life to be sup- 
ported by other people." But when the same eminent au- 
thority designates the procreative act as brute instinct, I 
think he is in great error, for that is not so. Conjugal affec- 
tion and the sentiment of love spring from the reproductive 
systems, through the reflex action of the brain, and these 
have their moral significance, and should not be branded as 
brutal, for upon their normal functions depends the perpet- 
uation of the race, and as it was so ordained by the Creator, 
it cannot be an unholy passion. 

To be physically strong and well are the prerequisites 
for happiness, and if we cannot transmit to our offspring this 
essential quality, it would be much better for society if we 
were not instrumental in bringing defective children into 
the world. The competitive struggle for existence is hard 
enough for the vigorous and robust; how much greater 
must it be for the constitutionally infirm? When these con- 
ditions of infirmity exist, they should influence our course as 
progenitors; this appears to me self-evident, and I trust in 
the wisdom that is innate to the human soul, that only the 
best ends will be subserved. 

An expedient that is to accomplish the object in view, 
must be in the nature of a wholesome sanitary measure, 
that violates no law of nature. The inordinate use of any 
preventive, coupled with excessive indulgence, cannot be 
without ill effects. Excesses must be studiously avoided, so 
as not to incur the diseases of which mention has alread}^ 
been made. The employment of a vaginal douche of the 
proper temperature, medicated with a little pure alcohol, is 
not injurious and is the most reliable of all preventives, 



100 HOME TREATMENT. 

provided it is intelligently used and without delay. The 
quantity of fluid to be used is a quart of warm water, of 
103 to 105 degrees Fahr., to which two tablespoonfuls of 
alcohol is added ; of this, three-fourths or all is to be douched 
through the vagina. 

The vaginal irrigation is to be undertaken immediately 
after the act; if sufficient time is allowed to pass, the sper- 
matozoa will have entered the mouth of the womb; then 
they are clearly beyond the reach of the wash. The warm 
water and the necessary paraphernalia are to be held in 
readiness so as to lose no time in making the toilet, nor 
should there be unnecessary exposure to the danger of catch- 
ing cold. The nozzle of the sj^ringe should always be of 
hard rubber, because that is not likely to rust or corrode. 
The syringe is to be kept scrupulously clean by means of 
occasional brushings in soapy water. Vaginal injections 
should never be taken in the morning, if the person is re- 
quired to exercise on her feet, and for the same reason,, 
should any husband have marital relations with his wife 
before rising in the morning, the wife is likely to suffer 
all day, either by soreness or pain or by a dragging sensa- 
tion of the womb and vagina. 

The same rule is to be followed in vaginal irrigation as 
for other purposes, the main point being to throw the fluid 
well up into the vagina, and that can only be done if the 
nozzle is carried directly backward and not upwards. No* 
violence or force is to be used, under any circumstance. 



•CHAPTER VIL 

CRIMINAL ABORTION OR FETICIDE. 

I have so far endeavored to give a cursory description of 
avoidable causes, which were inadvertantly or thoughtlessly 
encouraged, and it is to be hoped that my friendly reproof 
and counsel will incite my readers to modify their pernicious 
habits and direct the currents of their thoughts into chan- 
nels more or less in harmony with the hygiene that I have 
been at liberty to suggest. 

There are few persons, if any, who would voluntarily act 
and think in a manner that would be prejudicial to their 
physical or moral welfare, if they were educated to a stand- 
ard of knowledge that gave them an insight into the evil 
consequences. The law of self-preservation is innate in our 
natures, so that we are ready to cultivate the good and use- 
ful and shun that which may do harm. 

Among the avoidable causes there is none so prolific of 
disease as that which is traced to the premature expul- 
sion of the ovum or fetus from the mother's womb. 

This appears self-evident, when we stop to consider that 
the function of reproduction is at once by far the most com- 
plicated of the physiological processes of the female economy, 
so that its sudden interruption will naturally induce any one 
or all of the physical or pelvic ailments which we are called 
upon to discuss. 

For our purpose it will not be sufficient to consider the 

subject from a medical standpoint alone, because the thoughts 

drift involuntarily, as it were, from the physical into the 

metaphysical, from the material into the spiritual part of 

our nature. 

(101) 



102 HOME TREATMENT. 

It is not within the scope of this work to enter upon an 
inquiry into the scientific evidence of the existence of the 
soul or advance any argument whatever in support of that 
doctrine, but I assume the existence of an immortal soul to 
be a fact. 

What I will endeavor to explain is when and where this 
mystic union of the soul with the body takes place? Here 
the speculations of the medical philosophers have been con- 
tradictory, on account of attributing to the fetus different 
kinds of life, that is, an organic or vegetating existence at- 
tached to the mother's womb, and as such not possessed of 
sentient principle, until the real or spiritual life imbues the 
fetus, when it becomes a living soul. 

Hippocrates, the most famous physician of antiquity, 
who, even in the light of the nineteenth century, looms up as 
one of the most brilliant intellects that the world ever had, 
lent the weight of his judgment to this very unreasonable 
doctrine. 

He supposed that animation occurred from thirty to- 
forty-two days after conception. 

The Stoics went still further and maintained that there 
was no vitality until after birth and the establishment of res- 
piration. 

The Academicians were of the opinion, that life was im- 
parted to the fetus during the period in which the mother 
carried it in the womb, but they could not agree on the time 
when it began. Even the Roman Church, which, in the main, 
is right on this question, speaks of animate and inanimate 
fetuses. When it is remembered that there was no scien- 
tific physiology upon which the ancients based their opinions,, 
it is not at all surprising that, in the light of modern research,, 
they are shown to be all wrong. 

There is no time during the child's sojourn in the mother's 
womb that life is less active than at another, and any opin- 
ion to the contrary is manifestly absurd and unscientific. 

I appreciate the distinction between physical life, or vital 



CRIMINAL ABORTION OR FETICIDE. 103 

activity, and spiritual life, but the one must necessarily be 
in the other. 

A central fountain of physical force is consistent with 
scientific deductions, and physicists are inclined to admit 
such a source. Many of the phenomena of the material 
world are explained upon this hypothesis. The sun is sup- 
posed to be that central fountain of physical force which in- 
spires activity in matter on this planet. Matter in itself is 
inert and motionless ; the globe we inhabit has no energy in 
itself which could keep it in motion, but the forces playing 
on and around it impart to it its motive power. 

The life of any complex organism, such as that of man ? 
is in fact the aggregate of the vital activity of all its com- 
ponent partSj and each elementary part of the fabric has its 
own independent power of growth and development. If we 
contemplate the history of the life of a plant, we perceive 
that it grows from a germ or seed to a fabric, sometimes of 
gigantic size, — it multiplies its species, by the production of 
germs similar to that from which it originated. This it 
performs without feeling or thinking or any effort of its own. 
All the functions of which its life is composed are grouped 
together under the general designation of organic functions, 
or vegetative life. 

In the building up of the animal structure we have pre- 
cisely the same operations taking place, one minute cell 
added to the other, like the stone mason running up a brick 
wall, each brick representing a cell, until the structure is 
completed. 

The question that we are particularly interested in is 
whether this " animal life " which stimulates the growth of 
the fetus from its first inception, can be any the less sacred 
at one time than at another? 

There is a general impression among a large portion of 
the community that the fetus first becomes endowed with 
life at the period of quickening, which is between the fourth 
and fifth month of pregnancy. The time when the mother 



104 HOME TREATMENT. 

first feels the motion is considered the period when the child 
becomes animated, that is, when it receives its spiritual 
nature into union with its human nature. 

The English law recognized the truth of this infamous 
doctrine, in varying the punishment of an attempt to procure 
abortion according to whether the woman be "quick with 
child or not," and in delaying execution when a woman 
can be proved to be so, though the execution is made to pro- 
ceed, if she be not "quick," even if she be unquestionably 
pregnant. This was a most barbarous penal provision and 
hardly excusable in a savage nation, much less among a 
Christian people, because it is contrary to all fact, to all anal- 
ogy, to reason, and at variance with biological science. 

If the embryo or fetus is simply an animal growing in 
the mother's womb, until the period of quickening or birth, 
it would not be a crime to procure an abortion, at any time, 
before these events take place. No sacrifice of a human life 
would be involved, so that the act would be simply a "mis- 
demeanor" regulated by the degree of injury which the 
mother sustained as a result of the operation. This was the 
prevailing opinion for many centuries, until, in the year 692, 
the Roman Empire so amended its law that the procuring of 
an abortion at any time during the period of gestation 
was homicide, murder, to be punished with death. 

France patterned after the Roman law for a time and 
made criminal abortion punishable by inflicting the death 
penalty ; during the French revolution this law was amended 
by imprisonment for life ; and later, under Napoleon, in 1810, 
the law was again changed, and the punishment lessened. 

In England there has been a gradually growing moral 
sentiment to protect the defenseless child in its mother's 
womb, so that to-day England has so amended her law that 
the fetus has the same protection in the uterus before as 
after quickening, so that a conviction for the procurement of 
criminal abortion at any time during gestation from con- 
ception until birth is felony and punished by imprisonment 
or transportation. 



CRIMINAL ABORTION OR FETICIDE. 105 

In Germany the law makes abortion a State prison of- 
fense, and public opinion is in sueh a healthy state there 
that anyone justly accused of this crime is quite sure to 
meet with a punishment. 

In America legislation on this subject differs widely in 
the different States. In Massachusetts the barbarous dis- 
tinction, " before quickening and after," was still recognized 
a few years ago, so that the crime of abortion before quick- 
ening was not an indictable offense. In some of the States 
the laws are stringent and conform with the physiological 
facts of fetal life, but, like most of our " good laws," they are 
observed only in the breach. 

The essential peculiarity in the process of reproduction 
is the absorption of a small cell of the male, the spermato- 
zoon, by another small cell of the female, the ovum. This 
coalescence of the two, male said female cells, is the fertiliza- 
tion of the ovum, and constitutes conception. 

The spermatic fluid of the male holds in suspension a 
large number of very small bodies, or cells, which, from their 
usually remaining in active motion for some time after they 
have quitted the human body, have been erroneously con- 
sidered animalcules. A more thorough familiarity with 
these bodies, and careful microscopic examinations, can dis- 
tinguish nothing in the nature of structure within them. 
They are simply little oval, flattened, transparent cells be- 
tween the one-six-hundredth and one-eight-hundredth of 
an inch in length, having a little thread-like " tail," grad- 
ually tapering to a fine point. 

These measurements make the spermatozoa consider- 
able larger than the average red blood-corpuscle, which is 
one-thirty-two-hundredths of an inch in diameter. 

The spermatic fluid of a single emission of a healthy 
male contains thousands of these little ciliated cells, the cilia 
or tails of which are seen in an active vibratile undulatory 
motion, in the field of the microscope, wriggling hither and 
thither, like a school of frightened fishes. This lashing mo- 



106 HOME TREATMENT. 

tion is continued for hours, and under favorable circum- 
stances for days. In the cases of microscopical examinations 
of vaginal secretions of married women, for causes of sterility, 
I was able to establish their activity thirty-six hours after 
marital relations. 

Through this peculiar lashing motion the ciliated cells 
are propelled onward and upward, through the mouth and 
cervix of the womb, thence along its body to the openings 
of the Fallopian tubes, along which they migrate to the ova- 
ries of the female. In a healthy condition of the female gen- 
erative organs, hundreds of spermatozoa arrive at the ova- 
ries about the same time, a few hours or days after copulation, 
but as the ova ripen and are discharged only at regular in- 
tervals, the hundreds of ciliated bodies that travel thither 
are doomed to disappointment, and gradually lose their vi- 
tality, and perhaps are removed by absorption. 

Of all these hundreds of germs it requires only a single 
one to combine with an ovum, or a similar little cell of the 
female, to constitute conception. When this combination has 
been accomplished, a new being is inaugurated, another hu- 
man soul is started out, by the magic wand of nature, to 
go through the different spheres of evolution, of whose 
ultimatum we can have no clear conception, but this is per- 
fectly clear, that after this coalescence of the two germs, the 
die is cast and the female becomes then only the vehicle in 
which the creative forces are effecting their elaboration. 

Coition and conception are widely different processes, 
and require to be separately analyzed to be understood. 

Coition is always a physical act, a gratification of the 
senses, and, like many other human passions, is often abused 
by excessive indulgence, degenerating into lust. 

Conception, on the other hand, is purely passive, an or- 
ganic function, without consciousness on the part of the fe- 
male. 

Thus far there is a similarity in the organic processes of 
conception in all mammalia, so that their embryos cannot 



CRIMINAL ABORTION OR FETICIDE. 10 < 

be classified and assigned to their respective species in the 
early stages of their development. Physiologists are unable 
to say whether the one belongs to and will ultimately de- 
velop into a brute animal or a human being, yet one has the 
attributes of mental force, the elements of a soul, while the 
other is to follow a blind instinct, without the possibility of 
spiritual perception. Conception, in the one case, is simply 
a vegetative or organic function, while in the other there is, 
in addition, a spiritual effort to individualize a human soul. 

The creative energy of nature is separate and independ- 
ent of the sexual act, for it does not take place during copu- 
lation of the sexes, nor immediately after it, but hours or days 
after the act is accomplished. 

I am often called upon to say when and where the hu- 
man soul becomes associated with the human body? 

There is a divine life, or spiritual energy, that animates 
the soul from the spiritual realm. It is the correspondency 
of the physical force that animates the physical body. 

The term or phrase which I employ to designate this 
force is of less importance than the definition which is given 
to it, and upon this, of course, we must agree. I recognize in 
such an energy or power, the primal cause or force, behind 
and beyond the phenomena of nature. This force must be 
universal and omnipresent, hence spiritual; it must be the 
central source of supply for all spiritual things, so that the 
doctrine of Paul is scientifically in harmony with a ration- 
alistic view of the subject, when he says "in Him we live 
and move and have our being." 

The science of the conservation of forces teaches, that 
forces are never lost, that they are indestructible and eternal. 
We derive our spiritual existence from this central spiritual 
sun and inherit the quality of eternity with it. Mind is 
spirit and the soul is mind; this is the view of Spinoza, 
who, in the second part of his work " Ethics," employs the 
terms synonymously throughout the chapter " Of the Na- 
ture and Origin of the Mind or Soul." Mind differentiates 



108 HOME TREATMENT. 

man from the inferior animal creations, and can make 
him what he will. 

Professor Carpenter in his " Principles of Human Physiol- 
ogy," tells us, that when we first discern the primordial cell, 
which is to evolve itself into the human organism, we can 
trace nothing that essentially distinguishes it from that 
which might give origin to any other form of organic struc- 
ture. The earliest stages of its development consist in 
simple multiplication of cells by " duplicative subdivision," 
so that a mass of cells comes to be produced, amidst the 
several components, of which no difference can be traced; 
and this also finds its parallel among the simpler organisms 
of both kingdoms. There is nothing at this period to dis- 
tinguish the germs of man from that of any other verte- 
brated animal, yet in the course of nine short months a 
human being is developed possessing all the faculties of its 
progenitor, and how could all this come to pass, if not in- 
stituted at the moment of conception? 

It is at this time and moment, that an atom of the uni- 
versal spirit becomes separated and individualized, and the 
germ of a human soul is implanted, deep in the dark re- 
cesses of nature's laboratory. The ovum of the female 
and the germ of the male coalesce, imbued by the in- 
carnation of the immortal spirit, and no time can be more 
opportune for that union than at the very inception of our 
being, because the soul and the body must interact, one on 
the other. 

In the reproduction of man, there is a higher purpose 
than simply to multiply the species. The Creator can only 
manifest Himself, if he has intelligent souls or spirits as 
his creatures, and the reproduction of the human species is 
the natural means of bringing this about. 

The mystic union is accomplished at the time and mo- 
ment of conception, when a unit of the universal spirit be- 
comes individualized into a human soul. In the dark recesses 
of the mother's womb the ovum of the female and the germ 



CRIMINAL ABORTION OR FETICIDE. 109 

of the male, imbued by the immortal spirit, begin their 
growth and development together, this constitutes the triune 
of nature, from which the evolutions of body and soul take 
their beginning. 

Sexual instinct is not an unholy and depraved action of 
the human mind, but the necessary means to an end, a fi- 
nite instrumentality of the Divine mind to procreate the 
body, as an abode for the human soul. One of the attri- 
butes of the Creator is, in the very nature of things, to create, 
and he has thus endowed us, His creatures, for the manifes- 
tation of His creative power. He perpetually and eternally 
creates, and this has no reference to time, place or space: 
just as in the beginning, God created all things, so we rec- 
ognize the supreme hand, now, to-day, and forever, ever 
active in His natural element. 

The operation of nature's law may be contravened by 
the selfish, sordid, criminal acts of the human heart, but it 
cannot be frustrated. No one can console himself, that the 
invincible law of evolution is at the capricious behest of fi- 
nite man, and can be neutralized and obstructed at will; 
that would place a limitation on the Creator ; it would con- 
tradict the omnipotence of the Divine mind; it would place 
every life or soul at the mercy of the sordid conscienceless 
abortionist, and it would reduce the Divine origin of man 
and the soul's immortality to an absurdity. 

After the fetus is murdered, its soul continues to grow 
in the spiritual realm, an undying witness of the criminal 
infamy which deprived it of that earthly experience which 
nature intended for the children of men. It is the greatest 
crime against nature to kill off a human fetus, and prema- 
turely hurl into eternity a human soul, which has the same 
right to human experience as those already born, and, in 
the eyes of God, it is no less a crime than the murder of 
an adult. 

"Dust thou art, to dust returnest, 
Was not spoken of the soul. " 



110 HOME TREATMENT. 

The meaning of the term abortion is etymologically 
not to be born or not to be carried out, or, in other words, 
the premature expulsion of the fetus from its mother's 
womb, which is any time before it is capable of independent 
existence. This is according to the construction of the law 
of France, which means any time previous to the termina- 
tion of the sixth month of pregnancy. Abortion may be 
accidental, that is, it may be due to a casualty which was 
entirely beyond the control of the person suffering or going 
through an abortion, or it may be due to disease affecting 
either the embryo or the mother. 

The word " miscarriage " is generally preferred to that of 
" abortion " under the misconception that only the latter 
implies criminal culpability; this, of course, is an error, be- 
cause each word means exactly the same thing, with this 
difference, that one is of Latin origin, while the other is a 
plain Anglo-Saxon term. An abortion that is brought about, 
from other than natural causes, for the deliberate and avowed 
purpose of escaping from the inconvenience, privation, and 
cares of maternity, is always qualified by the adjective crim- 
inal. 

In the early months of pregnancy, it very seldom, though 
it occasionally does happen, that complications arise which 
place the life of the mother in imminent danger; that the em- 
bryo shares this danger in a corresponding degree is self- 
evident, because the fetus is unable to live independently of 
the mother any time before the expiration of the sixth 
month of gestation, so that the death of the mother means 
death to the fetus also. 

Through a fall, heavy lifting, or a sudden jar, a partial 
detachment is liable to occur between the placenta of the fe- 
tus and the wall of the mother's womb, that being the place 
where the blood of the one is exchanged into the blood of 
the other; from this, a hemorrhage may result, which will 
not yield to rest nor to other means which experience has 
taught to be useful. This loss of blood may be so great 
that, if it continues, the life of both will be sacrificed. 



CRIMINAL ABORTION OR FETICIDE. Ill 

In some women pregnancy may become complicated 
with convulsions ; these may be so violent, and recur so often, 
as to threaten life, and they are obstinate to all medicinal 
resources. 

Contingencies of the above nature evoked the scientific 
inquiry, whether abortions are ever justifiable. The answer 
must invariably be, that when it is clearly seen that the 
mother will surely die, and her fetus with her, an induced 
abortion becomes a justifiable obstetric resource, and under 
these circumstances it is not a crime nor even a sacrifice of 
the embryo, which would have perished with the mother. 

This rule of practice has been indorsed by the very 
highest authority in obstetric science, and the competent 
conscientious physician will readily draw the line between 
cases where so radical a measure becomes necessary, and 
where milder conservative measures will save the life of 
both mother and child. 

This cannot be a license for crime, except thai the sor- 
didly depraved time server may often try to stretch the 
threatening danger, but when this is done it is no less a 
crime of murder in the eyes of God, than if he had premed- 
itatedly and willfully slain a fellow-being. 

Such persons would not shrink from the perpetration of 
any crime, be it ever so heinous and black. These wretches 
are too cowardly to thrust a poinard into their victims on 
the highway, but ever ready to operate in secrecy in the 
abortion chamber, which is hidden from the eyes of man. 
I have known abortions being sought and abortions being 
committed, upon the flimsy pretext of being too weak, or 
too sick at the stomach. These are shallow subterfuges, 
that should not be countenanced by any conscientious prac- 
titioner. 

Many reasons are either imaginary or pretended, and I 
have often proved the fallacy of pretensions of an inability 
to carry a child, after women had gone through the abor- 
tion mills, by persuading them to become reconciled, for 



112 HOME TREATMENT. 

the time being, and that I would see them through to a 
happy end, and in no case were their fears justified by sub- 
sequent developments. There is a great deal in controlling 
the minds of these women, and directing them into whole- 
some channels of thought, and after that they become much 
happier and contented than ever before in their married 
lives. 

If the proposition is generally accepted, that abortions 
are justifiable as a therapeutical expedient, you open the 
door to the criminally inclined. Wily women will impose 
upon inexperienced practitioners by feigning physical suf- 
fering as a result of pregnancy, for the purpose of getting 
rid of their fetuses. There is a certain amount of hardship 
and discomfort associated with the average pregnancy for a 
part of the period at least, but this should be suffered with 
a mother's fortitude. 

The testimony of the early canons of the Catholic Church 
is very decisive on the crime of abortion, namely, " that the 
destruction of the fetus in the womb of its parent, at any 
period from the first moment of conception, is a crime equal 
in turpitude to murder." 

In Protestant countries abortions are on the increase, and 
in America it is one of the crying crimes of society, which 
has so thoroughly tainted and defiled the moral sense of 
American communities, that it has become next to impossi- 
ble to get a jury of twelve men who will agree on a verdict 
to punish this dastardly foul crime of murder, and the abor- 
tionist is thus encouraged in his iniquitous vocation. 

Professor J. Taber Johnson, of Maryland, stated in his 
annual oration before the State Medical Society : " The diffi- 
culty of conviction for producing abortion is shown in the 
statement of the Attorney-General of Massachusetts, that of 
thirty-two arrests and trials of abortionists in that State, in a 
period of eight years, not a single conviction resulted; and 
this fact is equally true of other States." This is indeed a 
sad commentary on the jury system, which often degener- 
ates into a farce or travesty on justice. 






CRIMINAL ABORTION OR FETICIDE. 113 

The practice of abortion is on the increase. This is not 
due to a single cause, but to a number, operating separately 
or co-operating jointly to the same end. Boarding-house 
or hotel life exercises a pernicious influence on the habits 
and morals of women. They sit all day in their apartments 
with indifferent occupations, or walk the streets between 
meal hours, without the inspiring thoughts which a cozy 
home alone can inspire. The maternal instinct languishes 
or dies completely out, and if women become pregnant 
while transiently domiciled, they scruple not against com- 
mitting this great crime, because their surroundings and 
accommodations may not be suitable for the changed rela- 
tions which motherhood brings about. If these people had 
their own little homes, were they ever so humble, their 
minds would run in different grooves, their lives would be 
much happier and offspring longingly desired, to fill the 
nooks in the little household. 

Want of domestic training in childhood lays the foun- 
dation for this crime. The American girl is trained with a 
view to display so-called refined accomplishments. This is 
done by totally ignoring domestic duties; these are to be 
shunned as menial and degrading; and when girls grow 
into womanhood and are married, they naturally look upon 
the ordinary household duties as drudgery, and quite un- 
becoming a woman of their attainments. There is nothing 
in their bosoms to arouse a pride in their homes ; quite the 
reverse ; that principle has never been inculcated in their 
youth, so that it is quite natural, that they hie to a boarding- 
house ; here they patronize the abortionist, or acquire pro- 
ficiency in that art themselves, from lack of nobler occupa- 
tion. 

Changed relations of the sexes destroy the maternal in- 
stinct. A man in a man's place, and a woman in the 
sphere for which God and nature intended her, is for the 
best interests of society. There is useful and profitable 
work for everyone, but each should labor in his or her re- 
8 



114 HOME TREATMENT. 

spective field of natural adaptability, in which there is 
plenty to do. There is, in the very nature of things, never 
anything gained by a woman doing a man's work, because 
there are always plenty of men around to do that, but while 
a woman is doing a man's work, she is necessarily neglect- 
ing a woman's, which it is physically impossible for any 
man to do for her. There is, consequently, an irretrievable 
loss to society from misapplied labor. When the great 
Napoleon was asked by Madam de Stael whom he consid- 
ered the greatest woman in France, his curt reply was, " She 
who bore the largest number of children." This is a tribute 
to motherhood, which no one can ridicule, for whom should 
we honor and respect more than the faithful, loving mother, 
who makes her life subservient to that of her children? 
There is no comparison between the self-denial of parental 
devotion and the devotee to amusements and fashion, or 
the slothful wife, who imposes sterility upon herself for the 
sake of pandering to depraved appetites and frivolous pleas- 
ures. 

Depraved associates pave the way to feticide. Some 
married women are so brazen and callous, that they have 
no delicacy in narrating their exploits of child murder 
with a triumphant air, whenever their acquaintances are 
patient and foolish enough to listen to them. These gad- 
ding persons often contaminate the minds of newly-married 
women, who had never for a moment entertained the 
thought of such an awful crime, and who would have made 
happy and contented mothers, were it not for the seeds of 
discontent and crime which were sown in their early mat- 
rimonial career. I have known mothers who had lost the 
delicate maternal instincts, without which a mother becomes 
a monster, advise their daughters and encourage them in 
the perpetration of this crime. 

Women of this type should be avoided like the dreaded 
mancanilla tree, for they poison the body and soul of pure, 
virtuous women, with whom they come in close contact; 



CRIMINAL ABORTION OR FETICIDE. 1 1 6 

they should be shunned by the young housewife like a pes- 
tilence, because their hands are scarlet with the blood of 
their own children. 

Unprincipled physicians are too often instrumental in 
abetting criminal abortions, and this for two reasons, namely, 
for the immediate lucre which is to them in hand paid, and 
also for ingratiating themselves into the confidence of their 
patrons, so that they may become their physician in other 
ailments. These are the pariahs of the profession, but, 
viewed from a business standpoint, they are very successful. 
It is through the looseness with which medical colleges are 
■conducted in this country, many of them not deserving the 
name of college, but more properly denominated a rendez- 
vous of self-constituted professors and ingenious advertising 
sharps, that the ranks of the profession are overcrowded, be- 
cause there is no scrutiny of moral character or professional 
attainments. These once labeled M. D.'s are determined to 
make a professional living, and nothing deters them from 
becoming particeps criminis, but owing to the corrupt and 
depraved jury system such a thing as punishing a physician 
for feticide is hardly ever heard of. I would advise my 
readers to shun each and every one of these criminal mon- 
sters as they would a pestilence. In general, "female spe- 
cialist" is but another name for abortionist, for the great 
majority of these self-constituted specialists do not know 
the rudiments of the science of gynecology; and women 
should exercise great precaution in whose hands they place 
themselves, or, rather, their lives. I know of no calling 
that is capable of rendering more good to humanity than 
the profession which I have made my own. 

The honorable physician occupies a position where he 
>can do a great deal to improve the tone and morality of the 
•community. He can do more than the pulpit in prevent- 
ing feticide, because he can depict the physical dangers and 
the moral turpitude, for it is to him that the deluded woman 
iirst goes for advice. It is with him to become an oracle of 



116 HOME TREATMENT. 

heaven; in the great majority of instances he can be instru- 
mental in saving human life and prevent the mother from 
murdering her own child. 

Maternity is the function of Divinity in human nature. 
Who can look upon a newly-born babe without seeing some- 
thing truly Divine, a manifestation of the Divine mind to 
create in his image, through the instrumentality of man, an 
innocent human flower, planted upon this earth to enjoy the 
fullness thereof, and what miscreant shall deny it its inher- 
itance ? 

That husbands are often the instigators of this crime is 
a fact well known to every physician of experience. I have 
known of a number of cases where wives came to my office 
with a woful tale of discontent on the part of their hus- 
bands, who did not want an "increase." Such men are not 
worthy the name of father or husband. They should have 
been emasculated before they ever approached the marriage 
altar, for they are below the brute creation and have no 
claim on human affections. The luxuries of life should not 
be considered as weighing against the birth of children, nor 
the expense of maintaining a large family considered as an 
excuse for feticide ; expenses had better be reduced and econo- 
mized in other directions, so as to meet the little extra in- 
crease, which the little stranger may cause. It is a fact, that 
among thrifty people, large families are no barrier to mate- 
rial success, for the blessedness of heaven rests upon them. 

I invariably solicit an interview with the recalcitrant 
spouse, and take the opportunity to tell him of the responsi- 
bilities which married life imposes upon married couples ; 
that the simple gratification of the carnal senses is lust,, 
which can and should be controlled by every person, and 
more in particular by married men. Matrimonial relations 
based only on libidinous pleasure are transient and eva- 
nescent ; incompatibilities arise, which cause conflict and 
dissension, ultimating in estrangement and divorces, but 
when soul is wedded to soul, then they are in harmony with 



CRIMINAL ABORTION OR FETICIDE. 117 

the music of the spheres, and children constitute the cement 
of an eternal wedlock which no man can rend asunder. 

Abrupt termination of pregnancy constitutes in itself a 
-diseased process in the tissues of the womb. We have al- 
ready learned of the gradual growth of the body of the womb 
to accommodate the growth of the child ; when abortion 
takes place there is a sudden check to this growth in the 
tissues of the womb, and a low grade of inflammation in- 
vades the entire structure. This inflammatory process fixes 
or hardens the womb so that this acquired enlargement 
often becomes permanent. The result is, that women can 
often trace the beginning of a long series of complaints and 
a shattered constitution to a so-called miscarriage. For this 
reason, the after-treatment of an abortion is of much greater 
importance, than after a regular normal delivery. 

After the close of a natural gestation, the child is born, 
and nature immediately sets to work to restore the womb to 
its healthy normal size. No violence having been done to 
the organ, there is no extra effort necessary on the part of 
nature to restore it. In a premature expulsion of the fetus, 
it is altogether different, the cell growth and the necessary 
physiological action to build up the womb, to house the rap- 
idly-developing fetus, was suddenly interfered with, and the 
shock which the vital activity sustains, diverts their ener- 
gies into a diseased process. Inflammation is to be guarded 
against, for it constitutes the root of all pathological condi- 
tions; chief among them is its prevention of fatty degenera- 
tion and absorption of the superfluous tissues of the organ, 
so that the womb remains heavy and enlarged. This en- 
tails a series of consequences; its size and weight may force 
it to occupy an unnatural and painful position, such as a 
falling of the womb or procidentia, or it may turn or even 
bend on itself into abnormal positions, called versions and 
flexions; these become obstinate to treatment in proportion to 
the time which elapses from the occurrence of the disease to 
the time when they fall under proper treatment. 



118 HOME TKEATMENT. 

Inflammations are limited sometimes to only portions of 
the organ ; this may be to the lining mucous membrane of 
either the body or neck. It may also invade the entire or- 
gan and even extend to the neighboring tissues and liga- 
ments. From the uterus along the Fallopian tubes to the 
ovaries inflammation may spread itself, causing abscesses in 
its wake and other complications which may require surgi- 
cal skill of a special nature to give permanent relief. 

Sterility is often the result of disease caused by abortion, 
and this should be another warning to thoughtless, giddy 
women, who desire no children in their early married life,, 
because it would interfere with their regular pleasure rounds, 
and so resort to abortions, which will, in all probabil- 
ity, make them entirely unfit to ever become pregnant or 
bear children. I have made an attempt to impress on the 
reader two things ; one of these is the flagrant violation of or- 
dinary and simple rules of health, the other the enormity of 
the crime of induced abortions, and to accomplish this I 
have avoided screening the subject by employing ambiguous- 
or finely-selected phrases, but have used plain terms which 
will not shock the pure or noble in heart and mind, but may 
the hypocritical, under the gauze of a false modesty. 



PLATE I. 




The Bony Pelvis in its relation to the entire body. 

From the author's original drawing-. 



CHAPTER VIII. 

ANATOMY OF THE FEMALE ORGANS. 

The bony part of the skeleton which is of particular 
interest to women, is the pelvis, so called, because it forms a 
basin or cavity which contains the most important female 
organs of generation. 

All the organs that are liable to the diseases of women, 
bear certain anatomical relations to the pelvis, so that the 
phrase, pelvic diseases of women, is often employed instead of 
the phrase, diseases of women, and pelvic surgery means also, 
surgical procedures, that may be employed for the relief or 
cure of these diseases. 

In confinement, the pelvis again comes into more or less 
prominence, for when the diameters of the pelvic canal have 
not their normal measurements, there is likely to be an ob- 
struction to the passage of the child into the world, so that 
mechanical means must be employed to overcome the obsta- 
cle. A broad pelvis in a woman is always a guarantee that 
there will be no insurmountable difficulty in the parturient 
act. 

Plate I shows the shape and locality of the bone in the 
human body, and gives also an approximate idea of the 
relation of the pelvis to the rest of the body. 

While the pelvis was referred to above as a basin or 
cavity, this is only partly true, for it is also a canal or pas- 
sageway, through which the child is born. The pelvis is 
divided by a prominent line into the false and true pelvis. 

The False Pelvis is all that expanded portion of the 
pelvic cavity which is above the rim or line that forms a 

(119) 



120 HOME TREATMENT. 

circular ridge, wnich marks the beginning of the bony 
canal to which the term true pelvis is applied. 

The True Pelvis constitutes the lower subdivision of 
the pelvic cavity. The circular ridge, which marks the 
division, constitutes also the inlet of the true pelvis, which is 
much smaller than the upper or false pelvis. Its walls are 
more perfect and their lower circumference is very irregular 
and forms what is called the outlet. Between the inlet and 
the outlet we have what is called the true pelvic cavity, in 
which the internal female generative organs are contained. 

These organs are located in the following order from before 
backwards : first, behind the pubis there is the bladder, and 
behind this is the uterus, and thirdly and a little to the left 
is the rectum. 

On each side of the womb, but also in the small or true 
pelvis, are the Fallopian tubes and ovaries. 

In this order the anatomical relations are easily remem- 
bered, and I believe that every woman should make it an 
object to learn at least as much of her own anatomy as I 
have laid down; because there is just little enough, so as not 
to make it tiresome, and quite enough to insure intelligent 
reading in the subsequent chapters. 

The points of differences between the male and female 
pelvis are entirely on the principle of adaptation to natural 
functions. The female pelvis has a broadness or greater 
prominence of the hips and a correspondingly greater pelvic 
cavity, while that of the male is altogether more massive. 

Its cavity is deeper and narrower, and the muscular 
eminences and impressions on the surfaces of the bones are 
much stronger marked. 

Plate II. This illustrates a cut or section, through the 
middle of the pelvis, from before backwards, so as to give a 
side view of the capacity of the true pelvis and of the organs 
that it contains. A careful study of this plate will per- 
manently fix the anatomy in the reader's mind. 

The lines a and 6 show the planes of the inlet and out- 



PLATE 




A Median Section of the female Pelvis and of the Organs 
that are centrally located. 

This plate is anatomically correct; the uterus resting- normally on and being 
elevated by the distended bladder. 



ANATOMY OF THE FEMALE ORGANS. 121 

let of the true pelvis, and it will be seen that within these 
lines the most important organs of the female are located. 

THE BLADDER. 

The bladder is situated at the anterior part of the pelvis. 
It is in relation, in front with the symphysis pubis, behind 
with the womb, some convolutions of the small intestines 
being interposed; its base lies in contact with the neck of 
the uterus and with the anterior w T all of the vagina. The 
bladder is said to be larger in the female than in the male, 
and is very broad in its transverse diameter. 

THE URETHRA. 

The urethra, is a narrow membranous canal, about an 
inch and a half in length, extending from the neck of the 
bladder to the external orifice. It is placed beneath the 
symphysis pubis, embedded in the anterior wall of the vagina, 
and its direction is obliquely downwards and forwards. Its 
diameter, when undilated, is about a quarter of an inch; 
behind the bladder and urethra, there is in regular order the 
uterus and vagina, and behind both of these, the rectum. 

THE PERINEUM. 

The Perineum is the muscular triangular body between 
the vagina and rectum ; it constitutes a segment of the female 
pelvic floor; it is the prop for all the pelvic organs, and for 
that reason every woman should know precisely what it is, 
and study the plate carefully until she understands it. The 
skin covering it is of a dark color, thin and freely movable 
over the underlying parts. There is no part of the pelvic 
anatomy so vulnerable, because in confinement during the 
passage of the child's head into the world, the perineum is 
put on a great stretch, and if the delivery progresses too 
quickly or is hurried, then the tissues have no time to 
stretch themselves so as to accommodate the child's head, 
and they must naturally tear. 

The awkward and officious use of instruments will do 
the same thing. I have seen the perineum torn asunder 
from this cause, from the vagina and back into the rectum. 



122 HOME TREATMENT. 

Plate III is one of the most instructive drawings that I 
could devise. It gives the reader a practical illustration 
of the internal generative organs and their anatomical re- 
lations to each other. This was a drawing from my own 
dissection, and the clearness and artistic reproduction is due 
to the skill of the engraver, Mr. H. X. Van de Casteele, of 
this city. 

THE VAGINA. 

The vagina is a membranous canal, extending from the 
vulva or introitus to the uterus. It is situated in the cavity 
of the pelvis, between the bladder in front and the rectum 
behind; its direction is not in a straight line, but curved 
from below backwards and upwards. When distended it is 
cylindrical in shape, but naturally it is flattened from before 
backwards, so that its walls are ordinarily in contact with 
each other. In length it averages about four inches in its 
anterior wall, while its posterior wall describes a segment of 
a larger circle, that makes it between one and two inches 
longer. At its commencement it is constricted, and at its 
upper extremity, where it is attached to the womb, it is 
dilated, so as to surround the vaginal portion of the neck of 
the womb (see Plate III, c) this is a short distance above the 
mouth of the womb. The attachment extends higher up on 
the posterior than on the anterior wall of the womb, which 
makes the posterior lip of the womb longer than the anterior. 

The mucous membrane is continuous above with that 
covering the vaginal portion of the uterus ; below it begins 
at the vulva. Running longitudinally along the anterior 
and posterior walls are distinct ridges or raphe; these are the 
columns of the vagina. 

The relations of the vagina to the neighboring organs 
can be studied to better advantage by referring to Plate I. 

Its anterior surface is concave, and is in relation with the 
base of the bladder and with the urethra. Its posterior 
surface is convex and connected to the anterior wall of the 
rectum for the lower three-fourths of its extent, the upper 



PLATE II 




The Vagina slit open to the neck or Cervix of the Uterus, 
showing the insertion of the latter into the former 



From the author's own design, beautifully illustrating:- 



a. Fundus (or Base) of the Uterus. 

b. Uterus' Body. 

c. Cervix, or Neck. 

d e. Vaginal part, forming the Anterior 

and Posterior Lips. 
f. Mouth of the Womb. 
gg. Interior of Vagina, illustrating- the 

Vaginal Folds. 



//. Perineum. 
ii. Round Ligaments. 
kk. Broad Ligaments. 
//. Uterine Vessels and Nerves. 
mm. Fringed Extremity of the Fallopian 

Tubes. 
;/ //. Fallopian Tubes. 
oo. Ovaries. 



ANATOMY OF THE FEMALE ORGANS. 123 

fourth being separated from the tube by a fold of the perito- 
neum, the recto-uterine fold, which forms a cul-de-sac between 
the vagina and rectum. Its sides give attachment superiorily 
to the broad ligaments, and inferiorily to the Levatores Ani 
muscles and recto-vesical fascia. 

THE UTERUS OR WOMB. 

The uterus is the organ of gestation, receiving the fecun- 
dated ovum in its cavity, retaining and supporting it during 
the development of the fetus, and becoming the principal 
agent in its expulsion at the time of parturition. In the vir- 
gin state it is pear-shaped, flattened from before backwards, 
and situated in the cavity of the pelvis, between the bladder 
and the rectum. It is retained in its position hy the round 
and broad ligaments (Plate III, ii and kk) on each side, but 
also by virtue of its anteverted position, and by the vagina and 
perineum. Its upper end or base (a) is directed upwards 
and forwards; its lower end, or apex, is directed downwards 
and backwards in the line of the axes of the inlet of the 
pelvis. It therefore forms an angle with the vagina. The 
uterus measures about three inches in length, two in breadth 
at its upper part, and an inch in thickness, and it weighs 
from an ounce to one and a half ounces in its healthy con- 
dition. 

The fundus or base is the upper broad extremity of the 
organ (a); it is convex, covered by peritoneum, and placed on 
a line below the level of the brim of the pelvis. 

The body (b) gradually narrows from the fundus to the 
neck. Its anterior surface is flattened, covered by peritoneum 
in the upper three-fourths of its extent, and separated from 
the bladder by some coils of the small intestines; the lower 
fourth is connected with the bladder. 

The posterior surface of the body is convex, covered by 
peritoneum throughout, and separated from the rectum by 
some convolutions of the intestines. 

Its lateral margins are concave and give attachment to 
the Fallopian tubes (n), above. 



124 HOME TREATMENT. 

The round ligaments (i) are attached below and in front of 
these, while the ligaments of the ovaries (o) are attached be- 
hind and below these structures. 

The cervix or neck of the womb (c d e) is the lower 
rounded and constricted portion of the uterus; around its 
circumference is attached the upper end of the vagina, which 
extends upwards a greater distance behind than in front. 

At the vaginal extremity of the uterus is, in the virgin 
womb, a round, but after childbirth a transverse aperture, 
the os uteri or mouth of the womb, bounded by two lips, the 
anterior of which is thick, the posterior narrow and long. 

THE FALLOPIAN TUBES. 

The Fallopian tubes, or oviducts (n) convey the ova from 
the ovaries to the cavity of the uterus. They are two in 
number, one on each side, situated in the free margin of the 
broad ligament, extending from each superior angle of the 
uterus to the ovaries. Each tube is about four inches in 
length; its canal is exceedingly minute, and commences at 
the superior angle of the womb by a minute orifice, the os- 
tium internum, or internal mouth, which will hardly admit a 
fine bristle; it continues narrow along the inner half of the 
tube, and then gradually widens into a trumpet-shaped ex- 
tremity, which becomes contracted at its termination. This 
opening is called the ostium abdominale, or abdominal mouth, 
because it communicates freely with the abdominal cavity. 
The margins of this extremity are surrounded by a series of 
fringe-like processes, termed fimbriae, and one of these proc- 
esses is connected with the outer end of the ovary. This 
part of the Fallopian tube is called the fimbriated or fringed 
extremity (m). 

THE OVARIES. 

The ovaries are analogous to the testes in the male. They 
are two oblong flattened and oval bodies, situated one on 
each side of the uterus, in the posterior part of the broad 
ligament behind and below the Fallopian tubes. Each ovary 






ANATOMY OF THE FEMALE ORGANS. L26 

is connected, by its anterior margin, to the broad ligament, 
b}' its inner extremity to the uterus by a proper ligament 
of the ovary, and by its outer end to the fimbriated ex- 
tremity of the Fallopian tube by a short ligamentous cord. 
The ovaries are of a whitish color, and present either a 
smooth or a puckered uneven surface. They are each about 
an inch and a half in length, three-quarters of an inch in 
width, and about a third of an inch thick, and weigh from 
one to two drams. 



CHAPTER IX. 

MENSTRUATION AND MENSTRUAL DISORDERS. 

The first appearance of the menses marks an epoch in 
the life of the girl which ushers in womanhood. It is the 
harbinger of the fruitf illness of the maiden, whose limbs 
now become rounder, and her hips widen out, while the 
breasts increase in size and the entire aspect undergoes pe- 
culiar changes, which all point to the approaching condi- 
tion of maturity. 

The term is derived from the Latin plural menses, meaning 
month, from moon, and it is an actual fact that the lunar 
forces seem to influence this physiological function, inas- 
much as it recurs every four weeks; most women menstru- 
ate during the first quarter, and only a very few during the 
new or full moon. 

During infancy and childhood, the sexual system of the 
female is inactive. The menstruation begins, in a temperate 
climate, about the fourteenth or fifteenth year of life, and 
ceases at the age of forty-five or a little later. 

The climate exerts a marked influence in determinating 
the first appearance of menstruation, which is further in- 
fluenced by the conditions of life and society in which the 
child is brought up. 

The diversity in the ages at which children menstruate 
in different countries cannot be laid to any constitutional pe- 
culiarities of the races. Observation has established that, 
when children of the same race and family are brought 
from a hot to a colder climate, the advent of the first 
menstruation changes. These girls menstruate not so 
young as their older sisters, but begin about at the same 
age as those who are born in the colder climate. 
(126) 



MENSTRUATION AND MENSTRUAL DISOKDERS. 127 

In hot countries, for instance in Africa, the negroes and 
girls in East India begin to have their periods at the age of 
ten to twelve years. In Sweden and Norway the average 
age for the first menstruation is sixteen, while further north, 
in Lapland, the ages vary from eighteen to twenty years. 
Next in order of importance, influencing the menstrual 
epoch, are the surroundings and food. 

In the same climate there are differences in the ages of 
children that are entirely due to these causes. Children 
who are pampered and who are nurtured in ease and luxury 
menstruate earlier than those of the poor or even of the 
middle class, who are brought up in habits of industry. 

We observe again a difference in the ages between those 
who are reared in the country or rural districts and the 
dwellers in the cities, whether it be in luxurious apartments 
or in tenement houses. The former grow older and stronger 
than the latter before the show begins. 

The temperament also greatly influences the development 
of the function; children who are nervous, irritable, and of 
a sanguineous temperament, menstruate earlier than those of 
sedate habits. 

The color of the hair and complexion are also indices of 
the respective appearance of the menses in the brunette and 
blonde. It has been observed that the dark-complexioned 
girls menstruate sooner under similar conditions than the 
blondes. Weakly children, who are delicate from some con- 
stitutional habit, or whose organism has suffered from dis- 
turbances of indigestion or suffered severely from teething 
in early childhood, menstruate earlier than their stronger 
and robust sisters. 

The quantity of the natural menstrual discharge, as well 
as the time or duration, varies greatly in health with differ- 
ent individuals. We first notice a slimy discharge, which 
soon becomes tinged with blood, and after one or two days 
it is almost of pure blood. The flow generally lasts three or 
four days, very seldom only one day, and sometimes a week 
to ten days. 



128 HOME TREATMENT. 

The monthly recurrence of the menstrual periods averages 
thirty years ; in temperate climates it may overreach this fig- 
ure a little, while in hot climates it comes much below this 
average. 

It does not follow as a rule that because a woman began 
to menstruate quite young, the change of life will take place 
earlier. This also depends much upon temperament, habit 
and mode of life. 

Physiologists have established, by carefully-prepared sta- 
tistics, that the average period of menstruation for women 
who began to menstruate early is thirty-three years, while 
those who commenced late have an average of only twenty- 
seven years. 

When a woman is forty-five years of age, we may, how- 
ever, as a rule, look for the change of life to set in; if she goes 
beyond this age, she may be taken as the exception. 

The cavity of the womb is the principal source from 
which the blood comes; while the ovaries and tubes are also 
greatly congested with blood, the amount that comes from 
them must be very small. 

The blood that comes from the womb is not different 
from blood coming from any other source; the changes and 
peculiarity of the menstrual show are due to its passage 
through the vagina, where it becomes contaminated with 
vaginal secretions. 

It is supplied from the blood-vessels of the womb, oozing 
through the mucous membrane of that organ, just as in a 
case of nosebleed. The entire womb is more or less swollen, 
and more especially the mucous lining, so that it corre- 
sponds, in many instances, to an inflammatory process, and 
for that very reason, a sudden check of the menstrual flow 
will often result in a regular subacute or acute inflam- 
mation of the womb. If the discharge of blood from the 
uteru's is in small quantities and a gradual, steady flow, it 
becomes so altered by the secretions in its passage through 
the vagina that it does not coagulate, but when it is poured 



MKXSTRUATION AND MENSTRUAL DISORDERS. 129 

out more rapidly or in larger quantities, the menstrual 
blood coagulates or congeals in the same manner as if it 
were derived from other sources. 

If a woman becomes pregnant, the menses as a rule are 
suspended during the child-bearing period, and usually re- 
main absent after the child is born so long as the woman 
nurses the child. I have known one woman who menstru- 
ated during her entire pregnancy, and another who had 
had eight children and never menstruated in her life, yet 
she was, and always had been, in perfectly good health : 
thus we see, that there is no rule without exceptions. 

An essential part of the menstrual function is that in 
which the ova or female germ cells ripen and are expelled 
from the ovary. The menstruation is only a reflex or side 
issue, to a more important part that is going on in the fe- 
male generative system; this is termed ovulation, or the rip- 
ening and expulsion of the human egg from the tissues of 
the ovaries. In the physiological process that operates in the 
economy of nature for reproduction, the ovaries are the prin- 
cipal organs. The other organs are simply accessory, and 
indeed many of the lower animals have no other organs 
than the ovaries for the perpetuation of their species. 

In the human female, the ovaries consist of a tough fi- 
brous tissue, between whose meshes are little cysts, which 
are called Graafian vesicles, and these little vesicles serve as 
the nests in which the ova or little germ cells mature. 

These ova which are imbedded in the Graafian vesicles 
are so small that they can only be seen by a high magnify- 
ing power. 

The activity of the ovaries begins at puberty, and ceases 
with the change of life, or menopause. 

The approach of the menses is signalized by a certain 
group of symptoms, which clearly indicate a congestion of 
the pelvic organs. 

There is generally a drawing sensation in the back and 
thighs, and a sensitiveness upon pressure in the regions of 
9 






130 HOME TREATMENT. 

the ovaries and the womb. There is a feeling of lassitude 
and weakness of the limbs, sometimes hot flushes changing 
off with chills, and often a feverish condition, which will 
last until the flow is fully established. 

Professor Dalton says : " In many birds, for example, the 
plumage assumes at this period more varied and brilliant 
colors ; and in the common fowl the comb or ' crest ' en- 
larges, and becomes red vascular. In the American deer, 
the coat which, during the first year is mottled with white, 
becomes in the second year of a uniform tawny or reddish 
tinge. In nearly all species, the limbs become more com- 
pact and the body more rounded ; and the whole external 
appearance is so altered, as to indicate, that the animal has 
arrived at the period of puberty, and is capable for repro- 
duction." 

In the human subject, the child now becomes conscious 
of the sexual instinct, however chaste or virtuous her mind, 
for we must not dull our intelligence with the idea that the 
sexual function is unholy ; it is no more so than to say our 
prayers ; so that an additional duty is now incumbent upon 
mother or guardian. 

The child must be made to know that she must be more 
reserved and guarded in her relations with the male sex; 
that she no longer can romp or play on the knees of male 
friends or visitors, and that it is dangerous and unbecoming 
to be left alone with them. A little later on, she must be 
apprised that she too may become a mother, and that that 
would be a great disgrace for one so young and not married. 
The child thus learns to protect herself against the insid- 
ious smiles and snares of the seducer, for he is ever abroad, 
and often family friend and trusted adviser. 

There are beings who are men in form only, but at 
heart are black villains, and selfish brutes. When the mis- 
chief is done, then it is too late to repent of a mother's neg- 
ligence, or to bewail a child's disgrace and man's perfidy ; 
the three combined make one of the most distressing scenes 
that it has ever been my misfortune to behold. 



MENSTRUATION AND MENSTRUAL DISORDERS. 131 

Successive crops of eggs ripen, and are discharged by the 
adult female at each menstrual period. 

I have already said that the ovum is contained in the 
Graafian vesicle, in which it grows and matures, as the fruit 
ripens on a tree, so the Graafian vesicle gradually ripens 
for the expulsion of the ovum, which gradually makes its 
way to the surface of the ovary. Within the Graafian 
vesicle the serous fluid accumulates, so that it ruptures and 
discharges its little ovum, which is taken up by the fringed 
extremity of the Fallopian tube, and carried along the ovi- 
duct into the womb, from which it escapes into the vagina, 
and is lost, provided conception has not taken place. 

Investigations have been made as to the number of ova 
certain mammalia discharge, and it has been found to cor- 
respond with the number of young that the animal pro- 
duces at birth. Where a litter consists of from three to 
twenty, as in the bitch and the sow, a similar number of 
eggs ripen, and are discharged at the period of cestruation. 

In the cow or mare, and in the human female, as a rule, 
only one egg is discharged at each period of ovulation. 

The discharge of ripened ova does, however, occur in ex- 
ceptional cases without any sign of the menstrual show, and 
the person may be susceptible to conception, so that we may 
reasonably infer, that ovulation constitutes the most impor- 
tant function of the menstrual period. 

MENSTRUAL DISORDERS. 

These are designated by different terms, not because each 
name signifies a particular disease, but simply an indefinite 
symptom of a diseased condition. In other cases menstrual 
disorder may produce symptoms that are common to widely 
different diseases. In other words, the phrase menstrual 
disorder, without being qualified as to its particular cause, 
means, from a practical standpoint nothing upon which a 
treatment can be intelligently based. Not any more than a 
cough which is simply an irritation of the bronchical nerves, 



132 HOME TREATMENT. 

and may be due to a bronchitis or pneumonia, or it may 
not be due to any pulmonary affection at all, as, for instance,, 
in the case where an aneurismal tumor presses on the bron- 
chial nerves, and excites severe paroxysms of coughing. A 
great many menstrual disorders are due, not to any disease 
of the generative organs, but to an affection of the nervous 
system. 

Menstruation may be precocious in some girls, and if 
the discharge is not accompanied with the usual symptoms 
of backache and some of the other symptoms that charac- 
terize the normal appearance of the menses, or if the girl 
is otherwise not fully developed, and has in this climate not 
reached her twelfth or fourteenth year, it constitutes a sign 
of a disease. If, however, the show recurs at certain inter- 
vals, it is not to be considered with the same degree of 
apprehension that it would be if it recurred at irregular 
intervals. 

The sanguineous discharge which shows itself at the 
genitals during an acute attack of an infectious disease, has 
no relation whatever with the menstrual function; this may 
take place in children at any early age. 

We often see girls who are not yet thirteen, who still wear 
short clothes and go to school, that menstruate regularly, 
but with this precocious menstruation there is also a corre- 
sponding development of the body which gives them a 
womanly appearance. Such girls should not be permitted to 
expose themselves to the inclemency of the weather, because 
they are much more liable to take cold, which may result 
in inflammations, than girls in whom the menses have not 
appeared. 

Girls of a scrofulous taint or other hereditary habits of 
constitution, often begin to menstruate prematurely; out- 
door exercise and cod liver oil with cold sponging on retiring 
at night are the proper resources for building them up. 

AMENORRHCEA. 

This term is employed for the purpose of designating an 






MENSTRUATION AND MENSTRUAL DISORDERS. 1 .'J.'i 

absence of the menstrual flow in persons who are old enough 
to menstruate, and in whom there is no physiological reason 
for its suppression, such as being too young, after the 
change of life, or during pregnancy and while nursing the 
child on the breasts. 

We find this disorder of the natural function of men- 
struation more among the women of the rich and affluent 
whose lives are spent in indolence and luxury; this is to be 
ascribed to lack of sufficient exercise to stimulate the nervous 
and sanguineous systems to the performance of their healthy 
functions. 

The amenorrhcea, or a retarded menstruation in young 
girls, is oftener the result of a general debility than of a dis- 
ease of either the womb or ovaries. We have here again 
about the same causes playing their pernicious role as in 
precocious menstruation in weakly children; that is, that the 
same causes produce directly opposite results. The scrofu- 
lous and hereditary taints always interfere with the proper 
and healthy development of the system; in amenorrhcea 
they appear to be a hindrance to the formation and growth 
of the red blood corpuscles. In some girls the suppression 
of the courses appears to be a wise conservative provision of 
nature, because the girls are already so weak and bloodless 
that even the loss of a very small amount would only in- 
crease the anaemia, so that in these cases it is not so much a 
question of " bringing on the courses " as of building up the 
constitution, and enriching the blood in order to bring about 
the desired result. 

Chlorosis, or the green sickness, is not simply an anae- 
mia or a bloodlessness, but a physiological incapacity of 
the system to prepare the required blood cells for the san- 
guineous fluid, and this is, indeed, the most frequent cause 
of the disorder under consideration. Chlorosis is a disease 
that is peculiar to the female sex, beginning as a rule at the 
age of approaching puberty, between the fourteenth and 
twentieth year, so that there appears to be a physiological 



134 HOME TREATMENT. 

relation between the blood genesis on the one hand, and 
the development of womanhood on the other. 

In some cases we can trace the impoverished condition of 
the blood to unhealthy dwellings, impure air, want of exer- 
cise, improper diet, nervousness, the reading of exciting, am- 
orous novels, and the practice of masturbation or self-abuse. 
On the contrary, the disease is often developed under the 
most moral and exacting discipline and hygienic surround- 
ings. 

I have known girls who lived in the country, enjoyed 
horseback riding, ate nutritious and wholesome food, and 
whose solitary moments were beyond suspicion, yet at the 
age of puberty they commenced to fade in color, and fail in 
strength, gradually growing paler and weaker, until they be- 
came chlorotic and bloodless. This can only be explained 
on the theory that the period in which nature was preparing 
the system for the purposes she had in view, caused a shock 
to the nervous system, which so disarranged the functions, 
that the sanguineous system did not respond to the growth 
of the generative system. 

Then there is another class of cases, where girls men- 
struate before they are old enough, and without their bodies 
showing any visible evidence of developed womanhood, who 
belong to the most obstinate cases for successful treatment.. 

The relative diminution of the red blood cells to the 
healthy standard is in some cases truly alarming. In the 
average healthy blood, there are, in one thousand parts of 
blood, one hundred and thirty parts of red blood cells; this- 
falls to sixty, and even forty parts in the thousand in the 
chlorotic patient. 

It is one of the peculiarities of this disease, that while 
the muscular tissue w T astes away, the fatty tissue is not only 
preserved, but it sometime increases, so that in a family of 
several girls, the chlorotic girl is considered the 'most fleshy/ 
but as fat is not flesh, the appearance is deceptive. 

When we stop to think a moment, that the red blood cor- 



MENSTRUATION AND MENSTRUAL DISORDERS. 135 

pusclcs are the messengers which absorb the oxygen in the 
lungs during the respiratory movements, and carry it to 
the different organs and tissues of the body, without which 
all tissue change would cease. And that the same red blood 
cells must return again to the lungs for exhaling the car- 
bonic acid, one of the waste products of tissue growth, then 
the diminution of the red blood cells in the proportion above 
given, must affect the entire system very injuriously. 

This is indeed the case; the natural respiratory move- 
ments are insufficient on the slightest exertion, so that 
patients tell us that when they walk a little fast, go up 
the stairs, or even sweep the room, they feel a shortness of 
breath. 

There are other symptoms that point to carbonic acid 
poisoning, which it will be interesting to review. A great 
majority of these symptoms are to be found in every case of 
chlorosis. The muscles become weak at first, because their 
nutrition is interfered with, and they waste away, and sec- 
ondly they become irritable from the poisonous presence of 
the carbonic acid, and so are often very painful. The patients 
are easily tired out; some, indeed, feel tired all the time, get- 
ting up in the morning as worn out as when they retired at 
night. 

The nervous system suffers as much, because the princi- 
pal nerve food is oxygen, and if there is no blood, there can 
be no oxygen ; a starved nerve is a painful nerve. We find 
neuralgias, affecting the different parts of the body, the rule ; 
when these are located in the external muscles, they are 
easily recognized, but when located in the deep organs, as 
the ovaries or the womb, they are generally mistaken for 
something else. The nerves of these individuals being in 
such an irritable state, it is natural to infer, that hysteria is 
often to be found as one of the complications, so that habit- 
ual sadness, and abnormal longings after chalk, lead pencils, 
and other indigestible articles are prominent symptoms. 

The circulatory system suffers derangements that are 



136 HOME TREATMENT. 

characteristic of chlorosis. Palpitation of the heart is a 
prominent symptom ; this is partly due to the irritation of 
the carbonic acid on the cardiac nerves, and partly to sensi- 
tiveness of the patient, owing to a morbidly-increased sensi- 
bility of the whole body. Chlorotic patients blush up at 
times, only to be followed by a green paleness that is pecul- 
iar to the disease. Pain in the region of the heart, and dis- 
turbances of the digestion, are sometimes prominent symp- 
toms. There is no feeling of hunger ; eating is not so much 
from hunger, but more from a sense of duty to keep up the 
strength. A heavy or full feeling is often experienced after 
a meal, and a sourish eructation will give relief to the op- 
pression, because the walls of the stomach are relaxed and 
in sympathy with the general debility. 

But in all cases of chlorosis the sexual functions are the 
seat of the greatest disturbance ; amenorrhea or the sup- 
pression of the menses is the most prominent symptom. 
The ovaries no longer seem to expel ripened ova, for there 
are no indications that point to their activity, because there 
is not only an absence of the show, but also an absence of 
the other signs that were noted when we considered menstru- 
ation and ovulation. 

There are a great many other diseases of which amen- 
orrhea is a prominent symptom ; these will be referred to 
when separate diseases become the subject of special inquiry. 

The treatment of amenorrhoea is, indeed, in the great 
majority of cases, the treatment of chlorosis, and that should 
be conducted on common-sense principles. If the child has 
vicious practices, they must be corrected, and everything else 
that has been mentioned as a cause must be abandoned. 
Children who were once robust and strong require electrical 
treatment, while those who were naturally weak require 
nourishing food and tonics. If there is in the entire phar- 
macopcea a remedy that deserves the name of a specific, it is 
to that one which I suggest in amenorrhoea due to chlorosis 
or anaemia. Iron preparations are very numerous; every 



MENSTRUATION AND MENSTRUAL DISORDERS. 137 

physician has his favorite prescription; some are to he praised 
more for their elegance and flavor than for any virtue that 
they possess. If in these cases any positive and decided re- 
sult is to follow the administration of iron, it must be given 
in such a mild form that it can be taken in great quan- 
tities without irritating the stomach or interfering with di- 
gestion. If the contents of the whole alimentary canal 
are saturated or impregnated with the ferruginous medicine, 
there will be astonishing curative effects. 

I have often observed chlorotic cases who have made 
the rounds of the different iron springs, and who have taken 
the numerous and various fancy elixirs, without the slightest 
perceptible effect, bloom up, after being fed, so to speak, on 
some harmless iron preparation, which was astonishing 
to themselves and surprising to their friends. The follow- 
ing is my favorite prescription for chlorosis or anaemia : 

NO. I. 

Take: Powd. Carb. of iron, sacch. (Germ.) 1 ounce 

Powd. Aloes 20 grains 

Powd. Tragacanth 20 grains 

Mix with sufficient water to make into a hard mass and 
divide into one hundred and fifty pills, and roll in pow- 
dered cinnamon. 

Take three pills three times a day and after three days 
increase to four pills at one dose three times a day, then 
after another three days increase to five pills as many times 
a day as before ; if these doses are not at first borne, begin 
with less, and if there is no costiveness or tendency thereto, 
omit the aloes. 

If there is reason to believe that the impoverishment of 
the blood is partly or wholly due to scorfulous taints, then it 
is advisable to take fresh, pure cod liver oil in conjunction 
with the iron pills; three boxes of pills are, as a rule, 
necessary to effect a cure. 

It happens quite often in chlorosis or anaemia that there 
is a distressing dyspepsia or indigestion with loss of appetite. 



138 HOME TEEATMENT 

In these cases I would first advise to put the stomach in 
order; this is done by first avoiding all indigestible food, 
such as cakes, pies, and puddings, and taking the following 
medicine : 

NO. II. 

Take : Bicarbonate of soda 2 drams 

Subcarbonate of bismuth ■ 2 drams 

Tr. of nux vom 2 drams 

Fluid ex. of rhubarb 3 drams 

Simple syrup 1 ounce 

Peppermint water sufficient to make, 8 ounces 

Take a tablespoonful three times a day, and if the bowels 
move freely take less. 

Hygiene in the treatment of every disease is to be an 
important factor ; all vicious habits must be abandoned. 

DYSMENORRHEA. 

Difficult or painful menstruation is the definition of the 
above word; all painful menstrual disorders that take place 
either before or during the menstrual flow come under this 
designation. 

The seat of the pain, when of a colicky nature, is in the 
uterus ; when a continuously dull ache is in the small of the 
back, it is located in the nervous plexus in the small of the 
back. The pain is very often in the ovaries and in- that 
portion of the peritoneal membrane which folds over all the 
pelvic organs and extends on the sides of the womb, consti- 
tuting the broad ligaments; when the pain is confined to 
these structures, it is principally felt below the stomach and 
over the lower part of the bowels. 

Painful menstruation is a prominent symptom of a great 
many diseases, and it often strains the ingenuity of the most 
clever specialist to trace the symptoms to their real cause. 

Obstructive dysmenorrhcea, as its name implies, is due 
to some hindrance or obstacle to the escape of blood from 
the cavity of the womb. The obstruction may exist in the 
neck of the womb, at its mouth, or in the vagina. When the 



MENSTRUATION AND MKXSTRIAL DISORDERS. 139 

obstruction is in the neck of the womb, it may be congenital 
or date from birth. The constriction or narrowness may be 
due to an acquired inflammation of the lining membrane of 
the neck of the womb. Every inflammation causes a swell- 
ing of the tissues, and if the inflammation continues, the 
swelling becomes permanent and a stricture is the result. 

Such strictures are often the result of the applications of 
strong caustics and meddlesome tampering by the ignorant 
specialist and abortionist. The application of the electrical 
current by means of the uterine electrode is the most mod- 
ern and effectual method of treating these cases successfully. 

Flexion of the womb is understood to be a condition in 
which the uterus is flexed or bent upon itself at a sharp angle, 
just as a rubber hose that is bent sharply on itself becomes 
compressed at the kink so as to shut off the flow, in this man- 
ner the flow of blood from the cavity of the womb is partly 
shut off, and. the obstruction is the cause of the painful 
menstruation. 

In some women who have flexion or a bent womb there 
is no obstruction, because the probe passes the canal freely; 
in these cases dysmenorrhea must be traced to some other 
cause. If it is clearly established that flexion is the cause 
of the obstruction, the most successful treatment is the elec- 
trical current. I have often had cases where little mucous 
growths no larger than a small marble, grew in the canal 
and obstructed, the free escape of blood ; after these were 
removed, the dysmenorrhcea ceased at once. 

Other obstructions may be due to a stricture of the vagina 
or some deformity of the hymen ; a very slight surgical ojd- 
eration will permanently relieve both of these hindrances. 

There is a much larger proportion of cases that suffer 
from painful menstruation in whom the uterine organs are 
perfectly healthy, but who are systematically injured by dis- 
honest or hungry specialists, by being subjected to local treat- 
ments. I have had cases of this nature fall into my hands 
very often. They had made the rounds of the specialists 



140 HOME TREATMENT. 

and had been made the innocent prey of avaricious pro- 
fessional competition, so that it is of the greatest impor- 
tance to distinguish this class of cases from those in which 
the pelvic organs are the seat of the difficulty. 

Nervous and congestive dysmenorrheas are particularly 
adapted for the hygiene of home treatment. Nervous or neu- 
ralgic dysmenorrhea is very often overlooked, and treated 
as a local lesion of the womb. 

The psychical exaggeration which many women experi- 
ence at the approach of the menses is abnormally height- 
ened in dysmenorrhoea. The pains in the back, in the hips, 
and in the lower part of the abdomen disturb the normal 
operations of the mind. The irritation of the nerves of the 
womb is often reflected to distant organs, and pain is felt 
in remote regions. Some women suffer only just a day or 
two preceding the flow, while others suffer severely during 
the entire period, so that they are forced to keep to their 
bed the greater part of the time. 

Professor William Goodell, one of the most profound and 
original female specialists in America, has this to say in a 
recent publication: "I have learned to unlearn the idea — 
and that was the hardest task of all — that uterine symptoms 
are not always present in cases of uterine disease ; or that, 
when present, they necessarily come from uterine disease. 
The nerves are mighty mimers, the greatest of mimics, and 
they cheat us by their realistic personations of organic dis- 
ease and especially of uterine disease. Hence it is that even 
seemingly urgent uterine symptoms may be merely nerve 
counterfeits of uterine disease. I have, therefore, long since 
given up the belief, which, with many, amounts to a creed, 
that the womb is at the bottom of every female ailment. 

"Nerve strain, or nerve exhaustion, comes largely from the 
frets, the griefs, the worries, the carks and cares of life. Yet 
although the imagination undoubtedly affects it, it is not a 
mere whim or imaginary disease, as all healthy women and 
physicians think ; but it is the veriest of realities. When 



MENSTRUATION AND MENSTRUAL DISORDERS. 141 

some flippant talker or some slipshod thinker scoffs at nerv- 
ousness as a sham disorder, I say to him: 'Can the bribe 
of a principality keep you from blushing when you are 
ashamed, or from blanching when you are afraid ? ' Under 
the flitting sense of shame or of fear these vasomotor dis- 
turbances are momentarily beyond your control; and so 
they are in the nervous woman, whose vital organs are, as 
it were — not transiently but — perpetually blushing and 
blanching under deficient brain-control over the lower nerve 
centers. 

u Strangely enough, the most common symptoms of nerve 
disorder in women are the very ones which tradition and 
dogmatic empiricism attribute to womb disease. 

" They are, in the order of their frequency, great weari- 
ness and more or less of wakefulness and inability to 
walk any distance, a bearing-clown feeling, headache, nape- 
ache and back-ache, scant, or painful, or delayed, or sup- 
pressed menstruation, cold feet, and irritable bladder, gen- 
eral spinal and pelvic soreness, and pain in one ovary, 
usually the left, or in both ovaries. The sense of exhaus- 
tion is a remarkable one; the woman is always tired, she 
passes the day tired, and she goes to bed tired, and she 
wakes up tired, often, indeed, more tired than when she fell 
asleep. She sighs a great deal, she has low spirits, and her 
arms and legs become numb so frequently that she fears 
palsy or paralysis. 

" There are many other symptoms of nerve strain, but 
since they are not so distinctly uterine, and, therefore, not so 
misleading, I shall not enumerate them. Now, let a nervous 
woman with some of the foregoing group of symptoms 
recount them to a female friend, and she will be told that 
she has womb disease. Let her consult a physician and ten 
to one he will think the same thing and diligently hunt for 
some uterine lesion. If one be found, no matter how tri- 
fling, he will attach to it undue importance, and treat it 
heroically as the offending organ. If no visible disease of 



142 HOME TREATMENT. 

the external organs be discoverable, he will lay the blame 
to the invisible endometrium, or on the unseeable ovaries, 
and continue the local treatment. In any event, whatever 
the inlook or the outlook, a local treatment is bound to be 
the issue." 

The nervous variety of painful menstruation is fre- 
quently due to impoverishment of the blood, which, as we 
have learned, is often the direct cause of irritable nerves. 
The same treatment as for chlorosis will give the desired 
relief: the treatment with iron pills. If the stomach is 
deranged from dyspeptic disorders, then my dyspeptic mix- 
ture, No. II, is to be given. But there are cases that are 
purely neuralgic without any apparently serious lesion of 
the blood; cases in which the neuralgia of the womb or 
ovaries is probably due to exposure to cold or some other 
indiscretion ; here the following recipe will effect a cure in 
the course of several months : 

NO. III. 

Take : Fluid ex. of black cohosh f ounce 

Fluid ex. of ergot | ounce 

Tr. of guaiacum ammoniated 3 ounces 

Glycerine 2 ounces 

Mix. Take a teaspoonful in a tumblerful of milk three 
times a day, between meals. 

Congestive dysmenorrhcea is oftener in the nature of an 
acute or sudden attack, except when it is due to a chronic 
inflammation of the lining membrane of the womb. It is 
often brought on by a sudden or inadvertent exposure, just 
at the time when the menses should make their regular ap- 
pearance. 

Persons of a plethoric habit and those who have been 
the subjects of inflammations either of the womb or in the 
tissues surrounding the womb, are more liable to this form 
of dysmenorrhcea than others. It will often be ushered 
in with a chill, followed soon with fever. There is head- 
ache, the skin becomes dry and hot, and often there is con- 



MENSTRUATION AND MENSTRUAL DISORDERS. 143 

siderable irritability of the bladder, straining of the rectum 
and diarrhoea. Unless the pain is due to an obstinate dis- 
placement, it yields to proper treatment. For the straining 
and irritable bladder a hot sitz-bath should be employed 
for. ten to fifteen minutes. In the absence of a suitable ves- 
sel for a sitz-bath an ordinary bathtub can be used by filling 
it six or eight inches with water, at a temperature of 104° 
F., and while sitting in the bath allow the boiling water 
to run slowly into it, so as to keep the temperature up. 
These sitz-baths should be taken several times a day, and 
after each bath the patient should rub herself thoroughly 
dry and wear flannel next to the skin. The extremities 
and feet should also be kept warm by wearing woolen hose. 

Towels wrung out of hot water should be carefully 
folded and applied to the lower region of the abdomen and 
then covered over with a thickly folded flannel cloth so as 
to retain the heat and moisture ; when the towel has cooled 
off repeat the dipping in hot water. 

The Femina vaginal capsules are of inestimable value in 
this class of diseases. They relieve congestion of the womb 
by allaying the irritation. The best time to use one is just 
before retiring, and after taking a sitz-bath, or a vaginal 
injection of hot water, or both. Persons who are of a cos- 
tive habit should pay particular attention that, about the 
time their monthlies come around, their bowels act freely, 
and to accomplish this purpose the Femina laxative tablets 
should be taken, one eacli night for several nights before 
the courses are expected. 

MENORRHAGIA AND METRORRHAGIA. 

By menorrhagia is meant, as the composition of the term 
implies, an excessive flow of blood at the regular monthly 
period; by metrorrhagia, a flow of blood from the womb at 
any time irrespective of the regular menstrual periods. 
Neither of these forms can be called a disease, as they are 
solely the symptoms of several kinds of uterine affections. 
In the course of our investigations, we will find that one 



144 HOME TREATMENT. 

of the most prominent and common symptoms of different 
womb diseases is hemorrhage of the womb. 

If the hemorrhage is the result of general debility from 
protracted nursing, the child must be weaned, and recipe 
No. I, with a nourishing diet, will effect a cure. 

Hemorrhage may be due to the presence of a fungoid in- 
flammation, tumors, or affections of the mouth or neck of 
the womb, or congestion of the ovaries. 

It is very often due to a "bad getting up" from confine- 
ment, where the womb has never returned to its original size. 
Sometimes it is due to a portion of the afterbirth that was 
retained in the cavity of the womb. It is also a symptom of 
cancer. As I have already said, it may be the symptom of 
so many different diseases that the proper course to pursue 
is to find an honest and competent physician to make a thor- 
ough examination, for the purpose of deciphering the real 
cause, and when that is discovered, it is as a rule, an easy 
matter to remove it and thus afford the patient permanent 
relief. 

There is no remedy which on the whole is so effectual 
in controlling hemorrhage, no matter from what cause, as : 

no. iv. 
Take : Fluid ex. of ergot 1 ounce 

Dose: a teaspoonful in a little water every four hours 
until the flow ceases, or until a physician is consulted to 
diagnose the case. In pregnancy, the administration of 
ergot is not admissible ; cold water compresses are also use- 
ful in checking uterine hemorrhage, and the utmost quie- 
tude should be observed. 

Nervous exhaustion from protracted confinement, or 
mental worry from the loss of a child or the death of a 
friend, may also cause uterine hemorrhage. The ergot is 
useful in these cases, with a change of air and scenery. 



CHAPTER X. - 

HISTOLOGY OF INFLAMMATION. 

Inflammations of the various tissues assume different 
forms as far as the gross appearances are concerned, but the 
underlying condition is precisely the same. The various 
types of inflammations that are produced by one and the 
same process are of considerable scientific interest, but to 
the practical and inquiring reader, whose principal object is 
to obtain sufficient information to be able to cure herself, it 
would be confusing were I to attempt a description of their 
differences. 

There is no word that is so often employed as inflamma- 
tion, as a designation of disease, and when we learn that 
there is only one kind of inflammatory process, whether of 
the brain, the lungs, liver, kidneys or bowels, the entire sub- 
ject of inflammatory diseases at once becomes greatly sim- 
plified, because if you understand one you must understand 
all. 

I will in the subsequent chapters speak only, or princi- 
pally, of inflammatory affections of the different organs that 
come within the province of this specialty, and I am con- 
vinced that if the reader will bear with me, so that I may 
take sufficient time and space to explain the most advanced 
scientific views of inflammatory processes, she will be more 
than compensated, by a clearer understanding of what will 
be said in succeeding pages. 

Inflammation comprises a series of phenomena, which 
partly take place in the vascular apparatus or blood vessels 
and partly in the tissues comprising the structure of the or- 
gan. Inasmuch as inflammation is not a single process, a 
definition of a few words is insufficient to convey to the 

10 /145) 



146 HOME TREATMENT. 

mind its real meaning. If I were simply to describe the pe- 
culiarities of the circulation, that characterize the inflamma- 
tory process, we should only have an incomplete idea of the 
changes that were taking place. 

Since the time of Galen, who lived two hundred years 
after Christ, inflammation was recognized by four cardinal 
symptoms, namely redness (Ruber), swelling (Tumor), pain 
(Dolor) and the increased temperature (Calor), To these 
modern pathologists have added a fifth symptom, which is 
lessened or diminished function (Functio l^sa). 

The above five cardinal symptoms can be established in 
the majority of the acute stages of inflammation: in the 
chronic or subacute variety, one or the other symptom may 
be absent, or so obscured as to escape notice. 

The nature and structure of the tissue materially modify 
some symptoms and exclude others, so that redness, pain 
and even perceptible swelling may be absent. Galen already 
in his time attributed the redness to an increased blood sup- 
ply and the swelling to an exudation of lymph or serum, 
through the walls of the blood vessels: this was as near the 
truth as scientists arrived, until within our own time. The 
discoveries in this field of science have been greatly en- 
riched in the last twenty years through the researches of the 
German school. Various theories have been advanced from 
time to time, as to the probable causes or processes that 
are going on in the tissues while inflammation is active. 
One observer believed that he had found the solution of the 
inquiry in a supposed spasmodic contraction of the capillary 
blood vessels, another in their paralysis, while still another 
adhered to the belief of a neurotic affection. Professor Vir- 
chow, the father of the modern school of pathological science, 
ascribed the conditions of the tissues to an irritable state of 
the inflammatory process, inducing an exaggerated cell 
growth; while his former pupil, Cohnheim, through an ex- 
tended series of newly-devised experiments, has conclusively 
proved that none of the theories advanced are supported by 
demonstrable facts. 



HISTOLOGY OF INFLAMMATION. 147 

Our present thorough knowledge of the combined dis- 
turbances and phenomena, that play their part in the vessels 
and tissues, of the body during the inflammatory action in 
living tissue is due to the unremitting toil of Professor 
Cohnheim. He was the first to speak from facts, as they 
presented themselves to his eye under the microscope. It 
was he who had the genius that suggested the examination 
of the whole process of inflammation, in the living tissues 
under the microscope. This he accomplished by narcotizing 
a frog, and while alive, but insensible to pain, a portion of 
the peritoneum or mesentery, which is almost transparent, 
so that the circulation may be plainly seen, was fastened 
with pins upon an ingeniously-devised rack or stage. The 
inflammation is now excited by etching the membrane with 
a little acid and a sharp needle, and then the object is placed 
under the microscope. If the operator is careful, so as not 
to tear or crush the vessels or tissues, and preserves the 
moisture, by spraying with warm water from time to time, 
the circulation and the abnormal processes of inflammation 
that are going on, may be observed and studied with great 
exactness for several hours. I will now describe what may 
be seen in the field of the microscope. 

The first change to be observed is in the vascular sys- 
tem and within the vessels themselves ; this begins with a 
widening of the small arteries, then of the smaller capillaries 
and veins. This increases the current of blood with greater 
velocity through the widened vessels. Sooner or later this 
rapidity of the current lessens; there is a marked slowness 
to be observed in the stream. The single or separate blood 
cells, which in the beginning of the observation could not be 
distinguished, can now be distinctly seen, especially in the 
veins and small capillaries, in which, from the slowness of 
tihe current, the blood accumulates. In the veins there now 
appears at the periphery of the current a pellucid plasmatic 
layer,in which there are wdiite blood cells, that have separated 
themselves from the main current; the white cells either 



148 HOME TREATMENT. 

float slowly along or adhere to the walls of the vessels. This 
phenomenon the Germans term " Randstellung der Farb- 
losen Blut Korperchen," which means, bordering of white 
blood corpuscles. Not long after the "bordering" of white 
cells, a change takes place in the cells themselves, that is 
very interesting. The white cells become elongated and 
spear-shaped at one extremity, which pierces the wall of the 
vessel, and after a little while the sharp extremities will 
appear on the outer surface of the wall of the vessel, and 
a little later on, indeed, the entire protoplasmic cell will 
have emigrated into the tissue, outside of the vessel. Or, in 
other words, the colorless blood cells will have passed through 
the walls of the vein or capillary, and this constitutes an 
extravasation. 

The first extravasated cells will soon be followed by oth- 
ers in great quantity, so that in six to eight hours veins and 
capillaries are surrounded with white corpuscles. In their 
normal destination these become organized into fibrous or 
granulation tissue; and for this reason, an organ that is the 
seat of chronic inflammation becomes immensely enlarged 
from this inflammatory accretion. We can now readily ap- 
preciate why the womb, liver or kidneys become augmented 
in size from inflammatory processes. Indeed, this applies to 
all growths and even to bone, and if a part is injured by a. 
cut, accident or disease of some sort, precisely the same proc- 
esses are at work to repair the lost tissue. It cannot fail to 
become apparent at once, that to understand the phenomena 
of inflammation is to possess the key that opens to our un- 
derstanding the operations not only of most diseases, but of 
the healing processes of wounds and injuries. In the course 
of the experiment we see also red blood corpuscles transude,, 
which are always accompanied with more or less fluid or 
plasma. 

The above detailed account seems to explain in a clear 
manner the different cardinal symptoms that have become 
recognized features of inflammation since the time of Galen.. 



HISTOLOGY OF INFLAMMATION. 149 

The great vascular activity explains the redness, swelling 
and increased temperature. The pain can be traced to the 
pressure from the exudation, to which the delicate nerve fila- 
ments were exposed, while lessened function would be the 
natural result of nerves or tissues so compromised. 

I made an attempt to initiate the reader into the science 
of inflammatory processes and if I have succeeded in mak- 
ing myself understood, then I am satisfied with having im- 
parted a most useful lesson, because there is no process in 
the entire field of disease that is so general ; it is almost safe 
to say that with the exception of functional diseases, there 
is perhaps no class of diseases with which an inflammatory 
process is not more or less associated. This is true of con- 
sumption, which is an inflammatory process excited by and 
around the bacilli or micro-organisms, and these inflam- 
matory nodules are called tubercles. The growth of a can- 
cerous tumor is associated with an inflammation. The 
development of a common boil is an illustration of an inflam- 
mation, breaking down or destroying part of the tissue which 
is inflamed. It is the same in inflammation of the lungs 
or pneumonia as it is in ordinary catarrh; the differences 
that are presented to the eye are only modifications of de- 
gree and peculiarities that are due to the difference of the 
tissues of which the organ or membrane is composed. 



CHAPTER XL 

URETHRITIS AND NEURALGIA OF THE URETHRA. 

Inflammation of the canal by which the urine is con- 
ducted and discharged from the bladder is termed urethritis. 

There is no organ of the female anatomy that is oftener 
the seat of local inflammation. 

The acute and chronic inflammations that affect the 
male urethra, also affect that of the female, only perhaps to 
a more limited extent, owing to the comparative smaller mu- 
cous surface of the tube, it being only from an inch to an 
inch and a half in length. 

Inflammation is oftener confined to this portion of the 
urinary apparatus than is generally supposed, because any 
derangements of these parts is at once attributed to the 
bladder, and it is an actual fact that many women have doc- 
tored uselessly for years, for the one, when it was the other 
that was diseased. Symptoms of urethral inflammations are 
so very similar to inflammations of the bladder that the 
points of distinction are easily overlooked. 

The trouble begins with frequent desire to void urine 
and a continual bearing down or straining sensation, which 
may be accompanied with a sense of heat suggesting to the 
minds of the most chaste and pure women, sexual desire, 
which the gratification of that indulgence does not relieve 
nor satiate, but, on the contrary, the sexual passion becomes 
only exaggerated. It is only the strongest force of character 
and Christian fortitude that keep some of these unfortu- 
nate women in the path of rectitude and virtue, and it is^ 
only the scientific specialist who can appreciate the real 
cause. In many instances women, truly noble in character, 

fl50) 






URETHRITIS AND NEURALGIA. 151 

have fallen from their high estate, because uncontrollable 
impulses swept them into the maelstrom of licentiousness, 
which might have been averted, if they had known of whom 
to seek proper advice. 

This irritation is often innocently and ignorantly ac- 
quired in early girlhood by fingering the parts, or practicing 
masturbation, which sets up an inflammatory condition of 
the urethra that becomes chronic, and in time may entail the 
terrible consequences to which I have already alluded. For 
that reason mothers should not be over-delicate ; they should 
not only keep a watchful eye on their children when in se- 
clusion, but should make it their holy duty to gradually ini- 
tiate their children into a knowledge of physiology and of 
the diseases that may result from any violation of youthful 
virtue. 

Why is it that many children who have been reared in 
an atmosphere of sanctity, children who have enjoyed from 
their earliest recollection moral and spiritual administration, 
have fallen into vice and depravity? The reader should 
stop to answer this question for herself, while I too will an- 
swer it for her. 

It is because moral teachers overlook the fact that human 
beings are dual ; that we are all animal, however spiritual, 
and that the functions of the animal nature must be under- 
stood in order that the spiritual nature can control them. 

A falso delicacy has entirely neglected this part of the 
education of our children, which I stamp as the height of 
stupidity and hypocrisy. 

Among other causes of this malady is hot and acrid 
urine, or gravelly discharges from the bladder, cutting and 
irritating the mucous membrane in its passage; abrasions 
of this nature often lay the foundation for ulcers. When 
the urine is in that condition, it is probably due to a com- 
plication of diseases of the bladder, the kidneys and the liver. 
A chemical and microscopical examination of the urine will 
be the only means of settling these questions. 



152 HOME TREATMENT. ._ 

The urethra often takes on the inflammations of the 
neighboring tissue or organs; disease of the vulva or of the 
vagina will spread itself to the urinary canal. I have seen 
cases in which the whole trouble was traceable to a catarrh 
of the neck of the womb. 

Gonorrhceal infection of the vagina will in the great 
majority of cases extend itself to the urethra as well as to 
the cavity of the womb and neighboring organs. 

If treatment in these complicated cases is to be success- 
ful, it must be directed to the disease in all of its strongholds; 
this, of course, can only be done under the direction of a 
skillful specialist. 

There is a predisposition on the part of the mucous sur- 
faces to become infected by eruptions of the eruptive fevers, 
and the urethra is particularly liable to this invasion. 
Children who have had the measles and scarlet fever will 
often be troubled with frequent and smarting micturition 
and after convalescence from all the other symptoms of the 
respective fevers, they are still more or less annoyed for weeks 
or months with a urethritis. I have had cases of this nature 
that dated back years. If the early treatment is neglected 
and the case becomes chronic, it generally spreads to the 
bladder, which also becomes similarly affected. 

Smallpox pustules are apt to break out in the urethra 
during the acute stage of the disease, and excite a very 
itching and painful urethritis. Dysentery in children may 
give rise to the disease. In adults I have noticed the affec- 
tion in connection with typhoid fever, but this generally 
passes off with convalescence. Hemorrhoids or piles give 
rise to urethral inflammation which does not yield to treat- 
ment, but subsides at once after the removal of the piles. 
The application of a Spanish-fly blister to any part of the 
body may also cause a stranguary or a urethritis. 

Mothers may become uneasy, as to the cause of the muco- 
purulent discharge from the urethra of their little girls. I 
have known them to entertain suspicion of some specific 



URETHRITIS AND NEURALGIA. 153 

infection being introduced into the genitals, in some myste- 
rious manner; a little inquiry into the history of every case, 
dispels these absurd delusions, and it will be found that pin- 
worms have caused the inflammation. In adults, however, 
the subject should be made the object of particular inquiry. 
During delivery, the passage of the child's head exerts great 
pressure on the urethra, so that it may be crushed or torn 
across. Women may be troubled with derangement from 
this cause for a long time, or for their whole lives, if the 
real cause of their ailment is not recognized. Displace- 
ments of the womb in different directions, principally when 
it is tipped backwards so that its neck impinges on the 
urethra or neck of the bladder, compresses the canal, so that 
its caliber is diminished, and a painful obstruction and re- 
tention of urine ensue. 

Papillated growths and mucous polypoids that were so 
small that they were hidden from external sight, but readily 
detected by scientific methods of examination of the urethra, 
by means of the urethral specula, were the exciting causes 
of some cases that came under my treatment. The unfor- 
tunate victims were under the impression that their kidneys 
or their bladders were diseased. The numerous quack 
medicines advertised for the cure of these maladies were 
copiously consumed, doing, of course, more mischief than 
good. The removal of the growths in each instance at once 
put a stop to any further inconvenience. 

In pregnancy, after the third month, the womb rises 
out of the pelvis, so as to accommodate its increasing size. 
This naturally drags the bladder upwards, and so stretches 
the urethra that it becomes sore and extremely irritable. 
To relieve this distress until the parts have accommodated 
themselves to their new relations, the Femina vaginal cap- 
sules are of the greatest value, and without the slightest ill 
effect arising from their use. Vaginal irrigations of hot 
water are also of decided benefit, especially before using a 
capsule. 



154 HOME TREATMENT. 

Mix. A teaspoonful to be given to an adult every four 
hours till relieved. 

The symptoms of inflammation of the urethra are al- 
ways very pronounced, because the mucous membrane of 
the urethra is the most sensitive part of the bladder. In 
the healthy state the coloring of the lining membrane is of 
a pale red ; when inflamed or catarrhal, it assumes a dark 
red, or a cherry color. The membrane is also considerably 
swelled and puffed, and feels hot to the touch, and imparts 
a burning sensation to the patient. The muco-purulent se- 
cretion excoriates or chafes the skin, so that the parts look 
angry and red in the neighborhood ; this is oftener observed 
in children. The characteristic symptom of frequently uri- 
nating is never absent, while very little is passed at a time, 
yet the straining to pass water continues, after the last drop 
is voided. 

The treatment is cleanliness to begin with. In grown 
people, the entire vulva and vagina must be rinsed out with 
a warm borax solution, in the proportion of one teaspoon- 
ful of the powdered borax dissolved in a quart of water. 
In little children the same object, that of cleanliness, is to 
be accomplished with a small ear syringe. 

After the external parts and the vagina are thoroughly 
cleansed, then, by means of a hard rubber syringe, No. 1, 
three or four syringefuls of clean borax water are injected 
into the urethra for the purpose of cleaning that too. To 
relieve the straining and frequent desire to micturate, which 
is accompanied with more or less pain, I give : — 

NO. V.C. 

Take : Fluid ex. of gelseminum 1 dram 

Sweet spirits of nitre 7 drams 

Mix. A teaspoonful in a wineglassful of water three or^ 
four times a day for an adult ; children in proportion. 

The patient must confine herself to a bland liquid diet, 
principally of milk, raw eggs beaten up in bouillon or broth. 
Vegetables may be eaten, but they are not to be seasoned with 



URETHRITIS AND NEURALGIA. 155 

anything but salt; and alcoholic liquors, wine or beer must 
also be suspended for the time being. 

NEURALGIA OF THE URETHRA. 

The female urethra is sometimes the seat of simple neu- 
ralgia, by which is meant a painful condition in which 
there is no apparent disease or inflammation of the tissues. 

This pain assumes often a spasmodic character; that 
there is a cause for this is certain, but it is as a rule remote 
from the sensation which attracts attention. It is often 
found to be the symptom of some of the diseases to which I 
have already referred. These are ulcerations, displacements, 
or inflammation and congestion of the neighboring organs. 
Abnormal growths or tissues will often be painfully reflected 
on the nerves of the urethra. I remember a case of internal 
hemorrhoids, which was never suspected by the patient be- 
cause there were no painful symptoms pointing to the rec- 
tum, but in which the urethra was very painful in its entire 
extent. The suffering from this urethral neuralgia had 
lasted for years, but disappeared at once, on the removal of 
the piles. I have called attention to a catarrhal inflamma- 
tion of the urethra, from stretching occasioned by the as- 
cending womb after the third month of pregnancy; there is a 
similar pathological process after the seventh month of gesta- 
tion, when the pregnant womb begins to descend again into 
the pelvic cavity, and this is particularly marked in the preg- 
nancy with the first child, when the pain is often very severe. 

If in a first pregnancy there is no abnormal dispropor- 
tion between the dimensions of the child's head and the 
maternal pelvis, or if there be no abnormal position of the 
child, then there is an obstetric rule that the womb, or 
rather the child's head, begins to descend into the pelvis after 
the seventh month of gestation, so that it can accommodate 
or conform itself to the maternal parts. This occasions a 
drag on the urethra downwards and backwards, which is 
painfully annoying, and there is a constant inclination to 
pass water. 



156 HOME TREATMENT. 

There are two mechanical methods of relieving this dis- 
tressing symptom; one is to obtain as much rest as possible 
in the recumbent position, and the other is to wear an ab- 
dominal supporter or bandage around the lower abdominal 
region, so as to take the weight off the urethra. The in- 
ternal medication consists of an occasional dose of a mild 
laxative medicine. 

In the newly married, the urethra becomes sometimes 
the seat of a painful spasmodic contraction; this is due to a 
tense hymen, which should be slightfy nicked with a pair 
of scissors. Exposures to colds will also cause neuralgia. 
Fresh beer and sour wine make the urine irritating, and 
also occasion painful symptoms. 

A thorough examination of the mucous membrane of 
the urethra which does not reveal any inflammatory condi- 
tion or abnormal growth, establishes its neuralgic character. 
The next step will naturally be to make such a careful ex- 
amination of all the surrounding tissues and organs, for the 
purpose of ferreting out the real cause. When the cause is 
removed or cured, it will also relieve the urethral pain. In 
the absence of a clear comprehension of the true nature of 
the malady, the treatment must be palliative. The sitz-bath 
is always one of the most palliative measures for all sorts of 
pelvic pains and aches. Vaginal injections of hot water, 
not too hot, from 105 degrees to 108 degrees, are another 
sort of general panacea, — the quantity of fluid should be 
large, from half to one gallon, in which a teaspoonful of 
pulverized borax has been dissolved. If the pain is very 
severe, then a Femina vaginal capsule should be used every 
night before retiring, and immediately after having used 
the vaginal irrigation. The bed should always be pre- 
viously warmed with a hot bottle, unless it is very warm 
weather. 

If the urine is irritating, a cupful of buchu tea three or 
four times a day, or German chamomile tea, should be drunk 
between meals. If these measures do not give relief, then 
consult an honest, competent physician, in whose integrity 
you can rely. 



CHAPTER XII. 

INFLAMMATION, CATARRH, AND OTHER DIS- 
ORDERS OF THE BLADDER. 

The female bladder is easier approached than that of the 
male. This is clearly illustrated in the anatomical Plate II, 
which should be thoroughly studied before this chapter is 
read. 

The bladder lies directly behind the symphysis pubis, 
above or in front of the vagina. On account of the com- 
parative shortness of the female urethra, to that of the male, 
the cavity of the bladder is also much more accessible 
through this channel, and if access through this communi- 
cation does not suffice, then the interior of the female blad- 
der may be exposed by an incision through the anterior 
wall of the vagina, but this resource becomes rarely neces- 
sary. Formerly we had to content ourselves with external 
appearances, that were confined to the external anatomy of 
the urinary canal on the anterior vaginal wall, aided only 
by a delicate sense of touch. Valuable as these means of 
examination sometimes were, they were far from satisfactory 
to either physician or patient. Now we are able to examine 
with the finger, aided with the eyes, almost the entire lining 
of the bladder. 

Professor Simon, of Heidelberg, was the inventive genius of 
this improved method of examination, by means of a series 
of graded specula or hard rubber bougies, which are known 
by his name. The specula are simply small, smooth, pin- 
shaped, hard rubber bougies, about three inches in length, 
beginning with a size that is three-tenths of an inch in di- 
ameter, to the largest, which is eight-tenths of an inch in 

(157) 



158 HOME TREATMENT. 

thickness. These are carefully introduced into the urethra, 
commencing with the smallest size, which is retained for a few 
minutes and then withdrawn, and the next size inserted, and 
this continued until the largest one has been inserted, or the 
required dilatation accomplished, either for the purpose of in- 
troducing the finger into the bladder, or exposing its lining 
membrane for inspection. While this procedure does not fall 
into the sphere of home treatment, it is of sufficient interest 
to women in general that they should know what can ac- 
tually be accomplished by the expert specialist. Were I to 
review the malformations, or dislocations, of the bladder, or 
the history of stones in the bladder, or other foreign bodies, 
that the female specialist is very seldom called upon to treat, 
I should only worry the patience of the reader with things 
that she would not readily understand. The same is true 
of growths and tumors of the bladder, which have princi- 
pally a scientific interest for the practitioner of medicine, 
but for the casual reader they are too profound in their de- 
tails for a clear understanding. 

INFLAMMATION. 

Inflammation of the bladder is in medical language 
termed cystitis. It presents itself under two varieties or sub- 
divisions, acute and chronic, depending on the duration, 
whether recent or protracted. 

The disease begins in the mucous membrane, and the 
acute inflammation comes on suddenly. It rarely occupies 
the entire mucous surface of the bladder, but usually occurs 
in irregular spots. Some spots are as large as the palm of 
the hand, while others are only the size of a ten-cent piece. 
The parts that are most frequently affected, are the neck of 
the bladder and its posterior wall, although no portion of 
its lining membrane is exempt from inflammation. 

It rarely happens that the inflammation spreads over 
the entire extent of the bladder, or that it invades the mus- 
cular tissue; if it should complicate the latter, it would involve 



DISEASES OP THE BLADDER. 159 

the peritoneum; this would add a very serious complication, 
namely, a peritonitis. Cystitis may be due to an extension 
of gonorrhoeal infection from the vagina and urethra, or 
from other purulent affections. Women who are unable to 
pass water after confinement, may be liable to the disease 
from retained urine, decomposing in the bladder and caus- 
ing inflammation. On the other hand, a filthy catheter 
used by a midwife or doctor who is careless or ignorant of 
the necessary antiseptic precautions, and who fails to brush 
and boil out the catheters, and uses one catheter on differ- 
ent patients, without the precaution of even thoroughly 
rinsing it, may give rise to dangerous cystitis. The most 
serious case that I ever have seen was directly traceable to 
this cause. If impure air gets into the bladder this will also 
excite cystitis; to prevent that, is to close with the finger the 
outlet of the catheter that is used for drawing off the urine, 
when withdrawing the instrument, a precaution seldom ob- 
served. 

Newly-brewed malt liquors, alcoholic stimulants taken 
in excess, diuretics of spirits of turpentine and cantharis, 
or highly-seasoned and rich food, are among the exciting 
causes; irritating injections into the bladder or vagina, and 
even cold-water injections into the vagina, must be added as 
exciting causes of this painful affection. Venereal excesses 
operate in exciting visceral inflammation, and when the 
slightest symptoms are felt, prudence and good common 
sense dictate continence. The first feeling that manifests it- 
self is a dull, heavy, aching sensation, immediately after uri- 
nating, and an involuntary inclination to further relieve or 
empty the bladder by pressing or bearing down. Soon after 
the first indication to void urine, there is another desire to 
empty the bladder, and the same symptoms repeat them- 
selves, only in a more aggravated form. The distress of 
micturition gradually becomes continuous so that during the 
short intervals between the times that urine is voided, and 
as the disease progresses, the pain becomes sharper. This is 



160 HOME TREATMENT. 

accompanied by a kind of gnawing uneasiness in the region 
of the whole bladder, which has intermissions, but is greatly 
increased when the desire to make water is felt. If the dis- 
ease progresses, the pain is now felt in the neighboring or- 
gans and a general constitutional disturbance manifests it- 
self. The patient will now generally have a severe chill; 
this is followed with heat and thirst and an increase in the 
pulse. The desire to void urine at shorter intervals becomes 
more prominent and only drop by drop, accompanied with 
distressing spasm and a burning sensation along the urinary 
canal. 

The region of the bladder becomes in the advanced stages 
of inflammation extremely sensitive and tender, and if the 
peritoneum is involved, even the weight of the bedclothes 
becomes intolerable. The limbs are drawn up and the body 
is inclined forward to relieve the tension of the abdominal 
muscles and their pressure on the bladder. 

The neighboring organs begin to sympathize with the 
advanced state of the inflammation at this stage; cutting 
pains are felt in the rectum, while darts of pain shoot from 
the bladder towards the groins and ovaries. 

Owing to the spasmodic action of the urethra, the bladder 
is never completely emptied so that the urine gradually ac- 
cumulates in abnormal proportions; the retained urea rap- 
idly decomposes into ammonia and the urine becomes very 
hot and irritating, thus greatly augmenting the suffering. 
Under these circumstances, the bladder may become greatly 
distended and feel as a sensitive globular tumor above the 
pubis. The retention of the urine may be complete, owing 
to a partial paralysis of the bladder and now complicated 
with spasmodic stricture. Nausea and vomiting are rarely 
absent in this stage, the tongue becomes coated and dry, 
while the expression is anxious and the fever very high. 

In the commencement of the disease there is some differ- 
ence in the symptoms of inflammation of the bladder which 
arises from the nature and seat of the inflammatory process. 



DISEASES OF THE BLADDER. 161 

If the neck of the bladder is mainly affected, the spas- 
modic desire to urinate is more pronounced, and the pain is 
felt low down in the vagina and anus, while the symptoms 
are higher up in the rectum, with constant inclination to go 
to stool, if the base or posterior wall of the organ is princi- 
pally involved. 

Acute cystitis runs its course in six or eight days ; under 
favorable circumstances and appropriate treatment all pain- 
ful symptoms will in that time have subsided, and the pa- 
tient will have entered upon a course of permanent recovery. 

If through a constitutional habit, or through neglect or 
improper treatment, the disease is not curbed, the result 
will be quite different; the inflammation may pass into a 
suppurative stage or assume the chronic form. 

The treatment in the acute stage will resolve itself into 
two different measures of relief; these are first to subdue the 
spasmodic pain and nervous excitement, and secondly, to 
quiet the local irritation. The pain is best controlled by 
morphine powders, one-fourth of a grain each, given every 
four hours. Warm teas of German chamomile or flaxseed, 
so as to dilute the urine, may be freely given. Hot vaginal 
injections of borax water have a remarkably soothing influ- 
ence; the hot sitz-bath is another useful adjuvant. It has 
been customary in this country and England, to apply hot 
water compresses or hot poultices over the hypogastrium, 
which is that part of the lower abdomen corresponding to 
the region of a distended bladder. 

After eight years of extended experience in this country, 
and a thorough trial of hot fomentations for inflammatory 
affections of the abdomen, I became convinced that the Ger- 
man method of cold-water compresses gives more relief and 
is more in the nature of an abortive, hence curative. 

I recommend to my patients, instead of the hot-water 
applications, a rubber bag, filled with broken pieces of ice, 
and applied over the region of the bladder. 

The bowels should be freely moved with castor oil or a 
dose of salts and senna, or by an enema of warm soapsuds. 



162 HOME TREATMENT. 

The food should be bland and of a fluid nature as nearly 
as possible, broths with an egg, milk gruels or bread and 
milk. 

CHRONIC CYSTITIS. 

If the acute attack of cystitis in the course of eight or 
ten days becomes modified, but convalescence is not estab- 
lished, then it is quite probable that the disease is drifting 
into a chronic stage. 

The mucus or slime that formerly accompanied the 
urinary discharge is now assuming the character of matter 
or has become mu co-purulent. While this is a very rare 
symptom of the acute variety of cystitis and usually of brief 
duration, in chronic inflammation it is one of the charac- 
teristics of the malady, and often lasts for a long time; the 
muco-purulent fluid is occasionally remarkably profuse. 

The pus is not always furnished by the free surface of 
the mucous membrane, but may be traced to small abscesses, 
situated in the tissue between the mucous membrane and 
the muscular wall of the bladder. The locality for the for- 
mation of these abscesses is principally at the neck of the 
organ, although there is no part of the organ that is entirely 
exempt from them. Fortunately, the abscesses generally 
point inwards or towards the cavity of the bladder, but it 
not infrequently happens that they break through and empty 
into the vagina or even into the adjacent bowel or abdomi- 
nal cavity. 

The occurrence of pus or suppuration is by itself so 
grave a process that it is always accompanied with certain 
well marked and stereotyped symptoms, which are cold 
chills, alternating with flushes of heat, increase of heat or 
fever, anxiety and restlessness. The pain now becomes dull 
and throbbing in character, and the burning or stinging is 
only felt when the patient urinates. When there are ab- 
scesses, the nervous derangement may be so great as to 
cause the mind to wander in delirium. Before the appear- 
ence of pus in the urine, nothing but a skillful examination 
can establish the existence of an abscess. 



DISEASES OF THE BLADDER. 163 

The treatment for suppuration of the bladder, when 
"limited to the surface of the mucous membrane, is alwaye 
curable with intelligently-directed treatment, which is the 
same as that for chronic catarrh of the bladder, to be de- 
tailed further on. 

ULCERATION OF THE BLADDER. 

This is perhaps seldom a condition by itself, but rather a 
complication of the preceding disease. The ulcers occupy 
the place of what were formerly little abscesses, that have 
broken into the cavity of the organ. Foreign bodies in the 
bladder by their direct pressure on the delicate tissues of the 
membrane have been the cause of ulcerations, that gave 
rise to dangerous hemorrhage. Earthy concretions or stones 
will naturally form in the bladder, and the end of a gum 
•catheter has also been found in the bladder broken off in the 
bungling act of drawing off the urine, or, what is more 
likely, by boring and poking within the cavity of the blad- 
der, with a catheter or bougie, by persons ignorant of pelvic 
anatomy or in the belief that the bougie was in the cavity 
of the womb, for the purpose of inducing an abortion. 

Ulcerations will always be accompanied with more or 
less inflammation or visceral catarrh, so that the symptoms 
wull fall under that head which has already been considered. 

CATARRH OR SUBACUTE INFLAMMATION. 

The mucous membrane of the bladder, like that of the 
nose, mouth or bronchial tubes, has its natural secretion of 
healthy mucous. When any of these membranes become 
irritated or congested from any cause, this natural secretion 
becomes so increased as to make a perceptible flow of the 
secretion of mucus, and this is what the term catarrh sig- 
nifies. Catarrhs always presuppose the existence of inflam- 
mation, which in its nature is subdued or mild, so that it 
has been qualified as subacute, which is intended to convey 
the idea that the tissue need not be red nor hot and swollen 
as is always the case in the acute form of inflammation. 



164 HOME TREATMENT. 

Chronic catarrh of the bladder is traceable to any or all 
the causes that have been enumerated in the acute processes, 
because every acute inflammation of the bladder may termi- 
nate in a chronic form. It occurs at any period of life, but 
it is most common in elderly subjects; it is always an at- 
tendant of ulceration of the bladder or some abnormal 
growth in the bladder. If the disease is once established and 
is due to a complication, it is liable to become aggravated or 
re-established after a brief subsidence by exposure to cold, 
excesses in diet and drink, or diseases of the vagina, uterus 
or rectum. 

The secretion of catarrh is white and glairy and resem- 
bles the discharge of leucorrhcea or ivhites. When disas- 
sociated with acute inflammation of the bladder, it comes on 
gradually, or in a slow, insidious manner; for this reason 
the term subacute inflammation is sometimes employed by 
authors, because there are no fiery symptoms at the onset of 
the affection. 

The urine is always more or less altered in character, 
because the inflamed mucous membrane predisposes the 
urine to speedy decomposition. There is frequent and diffi- 
cult micturition, and the entire region, but in particular the 
affected organ, is more or less sensitive and sore. 

The quantity of mucus which passes off with the urine 
varies greatly at different periods and in different cases. 
In the early stages it may entirely escape notice, being so 
small that if the urine is not saved in a vessel and accu- 
mulated for the twenty-four hours the mucus can hardly 
be detected; thus, the entire quantity of the above period 
may often not exceed two teaspoonfuls. When the disease 
becomes more advanced, the quantity of mucus may be 
equal to the quantity of urine that passes. The secretion is 
very thick and sticky, and settles to the bottom of the vessel 
or adheres to its surface. If there is pus mixed with the 
mucous secretion, it becomes a more serious question, and it 
may then be inferred that other organs are involved, the- 



DISEASES OF THE BLADDER. 166 

conductors of urine from the kidneys to the bladder, for 
instance, or the kidneys themselves. If the disease is con- 
fined to the bladder, the prospects for a cure are very favor- 
able; only when diseases of other organs in the neighbor- 
hood are the exciting causes of the malady are the chances 
for a cure correspondingly limited. 

The success of any treatment will depend in a great 
measure upon the nature of the exciting causes. These re- 
quire to be removed, if within the possibility of medical 
skill, before the catarrh can be made to subside. 

Should the mucous or muco-purulent secretion be very 
abundant, the bladder must be thoroughly rinsed out; first 
once every twenty-four hours, and afterwards every other 
day, so that the mucous membrane will be cleansed from 
all foreign irritating elements. I am employing for this 
purpose Thiersche's Boro-Salicylic solution. This of course 
can only be carried out by a skillful physician. 

When the disease is in its incipient stage it is amen- 
able to intelligently-directed home treatment. 

The most perfect rest of mind and body is one of the 
essentials to success, the entire suspension of stimulating 
drinks of an alcoholic nature, of which beer is the most 
irritating, and tea or coffee must be discarded. A milk 
and vegetable diet is the most beneficial to subsist on, and 
all condiments, even salt, must be dispensed with. 

If the bowels are costive they must be regulated either 
by means of enemas of warm water, or what may prove of 
greater and more lasting benefit is the use of Femina laxa- 
tive tablets. One tablet should be taken every night at bed- 
time, and if one operates too much, then one every other 
night may be all that is required. 

Demulcent drinks of flaxseed tea, or slippery-elm water, 
should be drunk freely, and for the catarrh of the bladder 
there is no prescription that ever gave me the same satis- 
factory results as this one : — 



166 HOME TREATMENT. 

NO. VI. 

Take: Borate of soda 2 drams 

Fluid ex. of gelseminum 1 dram 

Fluid ex. of belladonna x drops 

Fluid ex. of buchu 1| ounces 

Fluid ex. of senna 1 J ounces 

Distilled water 2 ounces 

Syrup of orange peel sufficient to make 8 ounces 

Mix, and take a tablespoonful or less three times a day- 
Wear flannel drawers and woolen hose, so as to guard 
against sudden changes of the weather. 

NEURALGIA AND NERVOUS IRRITABILITY. 

The bladder is often the seat of functional derangements 
that are characterized by a morbid sensibility and pain. 

The principal symptom of this disease is a frequent de- 
sire to urinate. A careful examination of the urine reveals 
nothing abnormal in the fluid that would point to the 
slightest affection of the bladder, nor are any of the symp- 
toms that characterize inflammation present. There is no 
mucous sediment, but in a large proportion of cases there is 
an abnormal deposit of the phosphates that would point to 
nerve waste. There is often a similar irritability in the 
vaginal canal, in fact, there is such a mutual sympathy be- 
tween the two, which can hardly be located in any one par- 
ticular organ. 

Hemorrhoids and constipation are sometimes found to be 
the cause. 

In women of a nervous temperament the bladder often 
becomes the seat of a steady neuralgic pain. Sometimes 
this pain is periodical, recurring every day and about the 
same hour and lasting the same period. This pain is of a 
lancinating character, and radiates from the bladder to the 
neighboring organs. I have noticed these symptoms, par- 
ticularly in women who had lived in malarial districts, and 
whose blood had become impoverished by malarial fevers, 
or from excessive hemorrhages due to some uterine trouble. 



DISEASES OF THE BLADDER. 167 

Sexual excesses and other abuses that lower the tone of 
the nervous system will also develop a neuralgic condition 
of these parts. Persons who seek relief from this distressing 
complaint must first abandon their vices before they can 
expect alleviation from any treatment. This affection is 
not in itself dangerous, but the frequent recurrence of par- 
oxysms of pain render life miserable. If the general system 
requires toning up, I would recommend the iron pills after 
Formula I, with a good liberal diet of eggs and milk. For 
immediate relief of the painful spasms, the sitz-bath and 
hot vaginal injections are of great value. And for the irri- 
table bladder I can recommend: — 

NO. VII. 

Take: Bromide of sodium 3 drams 

Fluid ex. of gelseminum 1 dram 

Water sufficient to make 8 ounces 

Mix, and take a tablespoonful three times a day. 

The gouty and rheumatic bladder is so very rare that a 
detailed description is hardly necessary. But it might be 
well to remind the reader that if she is of a gouty or rheu- 
matic disposition and has also bladder trouble, it may be 
due to the bladder being compromised or influenced by 
gout or rheumatism. In that case, appropriate treatment 
directed to the rheumatic diathesis will also cure the bladder. 

PARALYSIS. 

The female bladder becomes paralyzed from various 
causes; some of these are located in the organ itself, while 
others are due to disease of the brain or spinal cord. An 
obstruction to the flow of urine through the urethra causes 
the bladder to become overdistended with urine and in- 
duces paralysis. A prolonged pressure from the child's 
head during delivery is oftener the cause of transient paral- 
ysis than any other. It happens that lying-in women can- 
not pass their urine for several days after confinement. 
Violence from without, as a blow or a kick, may have a 



168 HOME TREATMENT. 

similar effect. This results from the pressure to which the 
bladder was subjected. Operations on the rectum, vagina, 
or any of the pelvic organs, are frequently followed by a 
partial or complete paralysis. In all these cases, there is 
only one precaution to observe, and that is to draw off the 
urine at regular intervals so as to avoid an enormous accu- 
mulation of fluid. 

The paralysis becomes dangerous and obstinate to treat- 
ment, in proportion as the bladder becomes abnormally dis- 
tended, and the length of time that the muscular tissues are 
under the excessive strain. 

In those cases where the paralysis is due to spinal or 
brain disease, there is little prospect of a cure. In other 
cases, as for instance after confinement or an operation on 
the rectum for piles or fistula, it generally passes off in a 
few days. 

Great care and cleanliness must be exercised in using 
the catheter, so that the bladder is not infected from filth or 
virus from another patient. A catheter that has been em- 
ployed on a patient who had her urine drawn off while she 
suffered from purulent catarrh or puerperal fever, will inoc- 
ulate a healthy person with the same disease, and in this 
manner diseases are often communicated. The bladder is 
exceedingly liable to infection. 

HEMORRHAGE. 

A discharge of blood from the bladder is not of frequent 
occurrence, but it occurs often enough to make it noteworthy, 
and women should at least know that there is such a thing. 
It oftener takes place in men than in women, as a symptom 
of some grave or serious disease, or it may be only a trivial 
disorder. Hemorrhage of the mucous membrane takes place 
very readily, owing to the delicacy of the tissues and the great 
vascularity of the submucous layer, and there is a much greater 
tendency to hemorrhage in some persons than in others. 

Persons who are weak and debilitated bleed much easier 



DISEASES OF THE BLADDER. 109 

than strong, vigorous ones, because the blood may become 
so thin or poor in fibrin that it greatly loses its property of 
coagulating. Some diseases bring this particular diathesis 
about, such as scurvy, also measles, scarlatina or small- 
pox. Worms have been found to make their way from the 
rectum into the cavity of the bladder, and caused profuse 
and even fatal hemorrhage. A violent fall of the body, 
rupturing an artery in the bladder, severe horseback riding, 
and venereal excesses, have all caused almost fatal hemor- 
rhages, to which must be added ulceration of the mucous 
membrane. The most profuse hemorrhage of the bladder 
that I was ever called upon to witness, followed drinking a 
strong decoction of wormwood; irritating diuretics, like 
spirits of turpentine or tincture of cantharides, are also liable 
to cause bleeding. Hemorrhage is always accompanied 
with frequent desire to pass urine and spasmodic pains at 
the neck of the bladder. The blood may also coagulate in 
the bladder, causing an obstruction. The treatment con- 
sists principally in keeping the patient very quiet, and a 
rubber ice bag should be applied over the region of the 
bladder; nothing but bland liquid food is advisable, but no 
hot drinks are permissible. If the urine does not pass, a 
soft rubber catheter should be employed for the purpose of 
drawing it off. 

Hemorrhages of the mucous membrane, whether of the 
bladder, the bowels or lungs, generally yield to the follow- 
ing mixture: — 

NO. VIII. 

Take: Gallic acid 4 scruples 

Tr. of digitalis i ounce 

Fluid ex. of ergot 1 ounce 

Simple syrup J ounce 

Mix, and give a teaspoonful in a little water every four 
hours; children in proportion. 

URINARY FISTULA. 

By this is meant a permanent unnatural opening into 
he bladder from without, through which urine escaoes. 



170 HOME TREATMENT. 

The situation of the female bladder, just in front and 
over the vagina, and also its attachment to a portion of the 
cervix or neck of the womb, exposes it to injuries, especially 
from pressure of the child's head during delivery. By re- 
ferring to Plate II, it will be seen at a glance how easily 
an accident can take place from this cause. It was at one 
time supposed that delivery by forceps was the most fruit- 
ful cause of this lesion. That this is likely to happen only 
where the instrument is in incompetent or bungling hands, 
there is no reasonable doubt. A thorough acquaintance 
with the entire subject has proved that there are other 
causes that are the mainspring of this, sometimes very se- 
rious accident. 

Indeed, the opposite view is now entertained by the pro- 
fession; that is, that prompt delivery by forceps will prevent 
the parts from being injured, when the soft parts, and par- 
ticularly the bladder, is under severe and prolonged pressure 
by the child's head. There is no question that there is 
greater peril to the mother and child, in undecisive delay, 
provided the attendant has the requisite judgment and ex- 
perience to act intelligently. 

The hypothesis upon which this is based is the restora- 
tive property that living tissue possesses, to regain its vi- 
tality, after it has been subjected to severe and inordinate 
pressure. This we may observe in our daily experience; 
when, for instance, we jamb or crush our finger, or a child 
has its fingers momentarily crashed between a closing door r 
the fingers are sometimes crushed flat, but upon being re- 
leased, they rapidly regain their shape and vitality. If the 
pressure were continued for any length of time, the blood in 
the tissues would have become congealed, and the circula- 
tion permanently shut off, so that recuperation would have 
been impossible, and the tissues would have sloughed or 
mortified. 

If the bladder, under the direct pressure of the child's 
head against the pubic bone, be subjected too long, the 



DISEASES OF THE BLADDEK. 171 

same results would naturally follow : the tissues could not 
regain their vitality, and they would either tear or subse- 
quently slough or mortify, which causes the fistula. 

The vagina and bladder, like every other tissue of the 
body, except that of the brain or nerves, will suffer a great 
deal of contusion for a short time, but if protracted beyond 
a reasonable length of time, it will be permanently destroyed 
or injured. 

A urinary fistula is always a serious malady, since it ex- 
ercises a deleterious influence upon the patient's health. If 
the opening is only small, a spontaneous cure may take 
place, but if it reaches considerable dimensions, it requires 
to be accurately adapted and stitched together. The best 
time for the repair of the injury, is six to eight weeks after 
the receipt of the injury. 

Rupture of the female bladder is comparatively rare, 
for the reason that women are not exposed to the same seri- 
ous accidents as men; but if women will persist in doing 
everything that men ought to do for them, the statistics may 
be reversed. When the bladder is distended and violence is 
brought to bear on the abdominal walls, corresponding to 
the region of the filled bladder, a rupture is likely to result. 
Surgical measures should at once be resorted to, so that the 
injury can be repaired before inflammation of the perito- 
neum sets in. 






CHAPTER XIII. 

ACUTE AND CHRONIC INFLAMMATION OF THE 

VAGINA. 

When speaking of inflammation of the vagina, reference 
is had to its mucous lining alone. It undoubtedly happens 
that structures or tissues beneath the mucous covering be- 
come involved in the inflammatory action, but this occurs 
so seldom that it is not of sufficient moment to make it the 
subject of an inquiry in a practical work. 

The mucous membrane of the vagina, like all other 
mucous surfaces, has its natural secretion for the purpose of 
lubricating and keeping its surface moist. In a perfectly 
healthy state, the color of the vaginal mucous membrane is 
a pale red, this becomes scarlet red upon irritation. In girls 
who are not irritated or women who have not been abused 
by sexual excesses nor infected by disease, the normal secre- 
tion is just sufficient to preserve the moisture of its surfaces, 
but not in such an excess as to be noticed as a secretion 
or discharge outside of the vaginal canal. There is a phys- 
iological exception to this normal rule, a few days before 
and after the menstrual period, when the mucous membrane 
of the vagina sympathizes with the general congestion of 
the pelvic organs. The mucous secretion becomes then 
greatly increased, amounting to a catarrh or flow, this, how- 
ever, is only transient and subsides with the cessation of 
the menses. This might with propriety be termed a natural 
or physiological catarrh. 

For convenience of description and corresponding with 
the anatomical changes and the sources of their origin, in- 
flammation of the mucous membrane of the vagina may 
be acute or chronic, simple or specific. 
(172) 



INFLAMMATION OF THE VAGINA. 173 

Acute inflammation in this instance is no different in its 
characteristic symptoms from inflammations elsewhere; it 
develops suddenly, and there is congestive swelling and 
pain. There is considerable heat in the parts, increased red- 
ness, and the canal is very sensitive. In the beginning the 
mucous membrane is dry and contracted, but after a few 
hours or a day, relaxation and moisture supersede. The 
secretion is very scant at first, but becomes more abundant 
as the disease progresses, its character also changes from a 
white, glairy mucus to a creamy, muco-purulent or yellowish 
discharge. The urethra may also become involved, and then 
the symptoms that were detailed in connection with urethritis 
are also present. 

Acute vaginitis may arise from a great variety of causes, 
but the worst case that ever came under my notice was the 
scalding effect of a hot-water injection, given under the ad- 
vice of a physician who had ordered the patient to use the 
water "as hot as she could stand it," and also told her "the 
hotter the better." This profoundly wise suggestion was 
carried out by the patient with a vengeance, for she used 
nearly boiling hot water, which she had tested by putting in 
her finger and quickly withdrawing it. The steaming fluid 
so scalded the vagina that a most pronounced acute inflam- 
mation of the vagina was the immediate result. I have had 
other cases of the chronic form come under my notice that 
were aggravated by similar advice, so that a word of warning 
against the thoughtless and indiscriminate use of hot-water 
injections will not be without value. 

The vaginal irrigations of hot water, as a general stimu- 
lant to the mucous surfaces, or as an alterative to stimulate 
the absorbents to increased activity in removing old pelvic 
exudations, deserve a recognized place as a useful therapeu- 
tic measure, often of the greatest value, but too hot or " as 
hot as the patient can bear it," is superlative nonsense and 
absolutely injurious. 

No water injections into the vagina that are kept up any 



174 HOME TREATMENT. 

length of time should be warmer than 110 degrees Fahr. 
and never should vaginal injections be employed without 
using a thermometer to gauge the heat. When the solution 
is medicated, 103 degrees should be the average temperature, 
but it should never exceed 107 degrees Fahr. Exposure to 
cold and moisture especially during the menses is promi- 
nent among the causes of acute vaginitis ; injury from pes- 
saries or coition, retained putrefying secretions in the vagina, 
or the application of chemical preparations, or injury during 
confinement, will all induce this disease. Prolonged nursing 
causes anaemia, which predisposes the system to catarrhs. 
During the child-bearing period catarrhs of the vagina are 
quite common, and excessive coition excites a very painful 
inflammation of the vaginal mucous membrane. 

Gonorrheal infection arising from a specific contagion 
gives rise to a very painful and dangerous vaginitis. The 
character and nature of the specific virus admits of no par- 
ticular description, because its infectious quality of a specific 
nature does not at all depend upon the physical appearance 
of the infectious discharge from the male. Whether it is 
yellow or greenish, muco-purulent or a glairy mucous dis- 
charge, establishes no criterion, but the presence of microbes, 
the gonococcus of Neisser; this, of course, a careful micro- 
scopic examination can alone establish. This much is true, 
that careful researches in Europe, by competent and reliable 
authorities, have established the fact, from carefully-prepared 
statistics, that this is a far more fruitful source of uterine 
diseases than was formerly dreamed of. 

A specific vaginitis has a greater tendency to spread it- 
self along the mucous tract of the genital organs of the fe- 
male than a simple non-specific catarrh. In the former the 
womb and Fallopian tubes become successively affected, as 
we shall learn more definitely when we have occasion to in- 
quire into the diseases peculiar to these organs. 

Acute inflammation of the vagina has pronounced symp- 
toms, and when any one of them is felt by the patient, she 
should lose no time in resorting to treatment. 



INFLAMMATION OF THE VAGINA. 175 

The first symptom that is generally perceived by the 
patient is a sense of heat and burning in the vaginal canal; 
this is also reflected in the neck of the bladder during mic- 
turition. As the disease develops, there is a constant desire 
to pass water frequently, and this becomes sometimes a 
prominent sign. A dull aching weight is felt between the 
vagina and rectum. After these have lasted for some days, 
an offensive discharge from the vagina ushers in the second 
stage, excoriating the skin around the vulva, and if the dis- 
ease should spread itself to the neighboring organs, there is 
a violent throbbing pain in the whole pelvis. 

Women who are suffering with acute painful vaginitis 
should take to bed; all pelvic diseases of any acuteness at 
all are treated at a great disadvantage when the patient is 
running around and on her feet. . The disturbance in the 
circulation, the exposure to cold from cold floors or damp side- 
walks, and the impossibility of preserving an equable tem- 
perature of the body, when out of bed, only aggravate the 
malady. 

The vagina is to be douched several times a day with 
half gallon of warm water, in which a half teaspoonful or 
one tablet of Femina antiseptic uterine lotion has been dis- 
solved, and when the canal is rinsed, a Femina vaginal cap- 
sule should be introduced, but only once a da}^, and that is 
preferable at bedtime. The feet and extremities should be 
kept warm, and in married women total continence should 
be observed while the slightest irritation and soreness exists. 
By the non-observance of this precaution, the best directed 
efforts will often be frustrated and many female diseases 
which are readily curable in the beginning become chronic, 
and a moment's reflection ought to make this clear, to any 
person of ordinary intelligence. 

If there is the slightest suspicion that the disease is of a 
specific nature, the treatment must be antiseptic in its na- 
ture. Your physician should be reminded of the possible 
nature of the disease, for doctors as a rule are ignorant of 
the dangers that ordinarily accompany gonorrhceal infection. 



176 HOME TREATMENT. 

Oppenheimer in Germany made experiments for testing 
the germicidal properties of various drugs on the specific 
germs of gonorrhoea, and he proved that a corrosive subli- 
mate solution of 1 part to 20,000 will kill the gonococci. 
Corrosive sublimate is the corrosive chloride of mercury, 
one of the most powerful of the mineral poisons, and while 
it is perfectly safe in the dilutions that it is employed in, the 
greatest precaution must be constantly exercised to keep the 
drug isolated and out of the reach of children, especially 
the "antiseptic tablets," of which mention will be made be- 
low, because little children and adults also might at first 
sight believe that they were candy. 

I am accustomed to employ the corrosive sublimate much 
stronger than the Oppenheimer experiments demand, a prac- 
tice which I base upon practical observations, while in the 
Berlin clinics, and that is in the proportion of 1 to 2,000. 
John Wyeth & Bro., of Philadelphia, and other manufactur- 
ing chemists, make compressed tablets or wafers, which are 
very convenient and easily handled by any person of average 
understanding. These are sold by the druggists in little wide- 
mouth bottles, properly labeled, so that the required strength, 
1 to 2,000, is obtained by dissolving one or two according to 
their strength in a half gallon of warm water. Whenever 
gonorrhoea is suspected, the vagina should be thoroughly 
rinsed out several times a day with the corrosive solution. 
If the patient fears mercurial poisoning, the antiseptic irriga- 
tion can be followed by plain warm-water rinsings as a safe 
precaution against mercurial absorption. 

CHRONIC CATARRH, LEUCORRHCEA OR WHITES. 

An acute inflammation of the mucous membrane of any 
organ may drift into the chronic or subacute form, so that 
any of the causes which give rise to the acute variety are 
among those that are to be looked for in chronic catarrh. 
The general characteristics of catarrh are the same, whether 
acute or chronic or whether located in the nose, throat, 



INFLAMMATION OF THE VAGINA. 177 

bronchial tubes or vagina. This fact greatly simplifies the 
whole subject of catarrhal inflammations, so that the gen- 
eral reader will find no difficulty in acquiring the necessary 
information for successful home treatment of this very 
common class of diseases. 

Chronic vaginal catarrh has been divided into two va- 
rieties, vaginal and uterine. The distinction depends upon its 
origin or complication. Vaginal catarrh has its origin in 
and is limited to the vaginal canal. I have already called 
attention to a purely physiological catarrh that accompanies 
the menstrual flow and which subsides with the cessation of 
the menses ; in addition to this, there is probably no woman 
who goes through life without at some time during her nat- 
ural existence having this disease or symptom. Often the 
discharge is so scant that it entirely escapes her notice, and 
not until it becomes annoying by its constancy and abun- 
dance do women seek assistance. 

In ancient times and until quite recently, it was consid- 
ered as a distinct disease, attributed to constitutional debil- 
ity or an indication of impure blood; these theories are 
now entirely discarded. The modern school of Gynecology 
has given it quite a different interpretation, and considers 
leucorrhcea rather a symptom of some local disease than a 
disease itself. Experience, and careful research in, the sick 
chamber fully corroborate the correctness of this view, so 
that a simple local chronic catarrh is the exception to the 
rule. The exception applies oftener to children than to 
adults. We find it in young babies or little girls of all ages 
as a result of diarrhceal discharges which are acrid and 
filter themselves into the vagina and by their sharp, irrita- 
ting action on the mucous membrane, excite at first an 
acute, and afterwards a chronic catarrh of these parts. 
Eruptive fevers have induced a similar effect upon the mu- 
cous membrane of the child's vagina and also upon that 
of the bladder; obstinate catarrhs are frequently traced to 
these fevers. I have known pinworms to make their way 
12 



178 HOME TREATMENT. 

from the rectum into the vagina and by their irritating 
presence excite in the little child a very distressing vaginal 
catarrh. 

The irritation or itching which the inflammation and 
decomposed secretion cause, makes the child involuntarily 
dig or scratch her vulva, which of course only aggravates 
the disease, and which has already been mistaken for pre- 
cocious masturbation, and will undoubtedly often be so con- 
sidered again by superficial observers. In later years a 
subacute inflammation of these parts will undoubtedly de- 
velop this pernicious practice, and I have known several 
cases myself where young girls became physical wrecks 
from a combination of chronic vaginal catarrh and self- 
abuse, no one ever dreaming of the real morbid condition, 
but attributing their decline to everything else but the 
right cause. 

There is another complication that may arise from ca- 
tarrhal inflammation in little children, and that is an ad- 
hesive inflammation of the vaginal walls ; that means that 
the sides of the vagina may partly or completely grow to- 
gether, and thus change the normal diameter of the vaginal 
canal. In after years this may entail frightful suffering, 
either by mechanically obstructing the escape of the men- 
strual blood or otherwise interfering with the normal func- 
tion of the canal. There are many diseases from which we 
suffer in adult life for which the foundation was laid when 
we were young, through the ignorance of our parents. 

The stormy symptoms that usher in the acute form are 
absent in the development of the subacute or chronic vari- 
ety. This disease begins sometimes so insidiously that the 
patient may not be aware of its existence for quite a while. 
The secretion may not be at first changed in its character, 
save that it is noticed in greater abundance. In the course 
of time, the nature of the secretion will be greatly changed, 
from a white glairy discharge into a grayish opaque se- 
cretion ; this will be tinged greenish some days and be of a 



INFLAMMATION OF THE VAGINA. 170 

muco-purulent aspect. In the great majority of cases it is a 
whitish cheesy discharge from which the names leucorrhwa 
or whites have been derived. 

The color of the vaginal mucous membrane in chronic 
catarrh is of a bluish red tint, and its surface presents in 
places granulated patches, that bleed easily when they are 
touched. The vaginal walls are relaxed, so that women 
often complain that they have a sensation of "feeling open; " 
this is indeed the real state of affairs; the walls of the 
vagina may become so relaxed as to constitute a prolapse 
of the anterior portion or wall of the vagina, dragging the 
bladder and womb down with it. 

A great many of the so-called "falling of the womb cases" 
.are no falling of the womb at all but simply a relaxed va- 
gina, in which the wearing of pessaries or any other me- 
chanical uterine supporter will actually do a great deal of 
harm. 

The treatment of vaginal catarrh is principally local, 
when there are no constitutional complications. Of course 
there are rules of conduct that apply to all catarrhal pa- 
tients, whether the catarrh is of the genitalia, of the nose or 
throat or of the bronchial tubes; these rules constitute the 
hygiene of catarrh, a subject which is discussed in a separate 
chapter in this work to which the intelligent reader is re- 
ferred. 

The main feature of the treatment consists in thorough 
cleanliness of the vaginal canal and in the use of a soothing 
lotion. This object is best accomplished by the use of the 
Femina antiseptic lotion and in the following manner: Dis- 
solve one tablet or half a teaspoonful in a cupful of hot wa- 
ter and then add this to a half gallon of warm water of a 
temperature of 103° F., and by means of an elastic bulb syr- 
inge, use the entire quantity at one time. If the discharge is 
profuse, or if any offensive odor is perceptible, then the vag- 
inal injection should be made several times a day. 



180 HOME TREATMENT. 

In case there is soreness and pain in the pelvis, and 
there generally is, a Femina vaginal capsule should be in- 
troduced into the vagina, just before retiring. 

When the patient feels a dragging sensation, or such 
symptoms as would indicate a prolapse (falling down) of 
the vaginal walls from weakness or relaxation of the col- 
umns and muscular tissue which give them support, then 
the Femina antiseptic uterine lotion should be used, as 
before described, with this difference, that double the quan- 
tity should be dissolved in the cupful of hot water, and then 
added to the half gallon of warm water of the same tem- 
perature and used in the same manner. When the Femina 
antiseptic uterine lotion is used in its double strength, the 
remedy loses nothing in its healing effect but becomes more 
astringent, strengthening, and disinfectant. 

Be sure that the nozzle of the syringe sweeps the entire 
vaginal cavity, and if the above quantity of fluid should 
not be sufficient to thoroughly cleanse the vagina, then use^ 
double the quantity of fluid. 

With this prescription I have cured cases of leucorrhcea 
of twenty years' standing which had gone through the ordeal 
of all the different treatments that they were capable of un- 
dergoing. 

I would recommend to those patients who feel their 
wombs dragged down, the knee-chest posture, that means, to 
kneel down on the floor with the hips elevated as high as 
possible and the chest close down to the floor. This position 
rolls the abdominal organs upwards and forwards, and thus 
naturally draws the womb and vagina into their normal 
positions, much better than any mechanical appliance or 
operator can possibly accomplish it. It simply allows the 
relaxed organs, through the natural law of gravitation, to 
gravitate where they belong. It is necessary to retain this 
kneeling position for only ten or fifteen minutes, repeated 
twice a day, say night and morning, and the curative effect 
is truly wonderful. 



INFLAMMATION OF THE VAGINA. 181 

When I speak of the curative measures of displacements 
in general and of falling of the womb downwards and back- 
wards in particular, I will give a detailed description of the 
knee-chest position. 

There should be a choice in selecting a vaginal syringe 
or a syringe for vaginal bathing. The " fountain syringe " 
has several objections that are insurmountable. In the first 
place, the quantity of fluid that is to be used is limited by 
the capacity of the reservoir, or in order to replenish it, the 
oven tenor of the rinsing is disturbed. Another objection 
is, that the convenient peg upon which to hang it is not 
always present, or a shelf upon which to rest it not high 
onough ; then there is not the control over the stream that 
is desirable, so that considerable confusion arises at times 
from the fluid wetting things that had better be kept dry. 
For these reasons I prefer a bulb syringe. 



CHAPTER XIV. 

HYGIENIC MEASURES FOR CATARRHAL DISEASES 
OF THE FEMALE ORGANS. 

No treatment for catarrhal inflammations in general and 
of the pelvic organs in particular is certain and complete 
without special attention being given to certain laws or rules 
that are laid down for the preservation and attainment of 
health, and these comprise one of the collateral departments 
of medical science which is termed hygiene. 

What the skin or integument is to the exterior of the 
body, the mucous membrane which lines the respiratory 
passages and other organs is to the interior of the body. 

The mucous membrane is only a modification of the 
skin, and while it differs in its glandular composition in the 
different organs that it lines, in the main, it retains the com- 
mon characteristics of the skin or outer covering of the 
body. 

The corium or fibrous layer of the mucous membrane is 
analagous to the derma of the skin; and it is in fact a con- 
tinuation of it at the orifices of the body. 

The corium of the mucous membrane supports an epi- 
thelial layer of cells that are of various forms, differing in 
the different organs that it lines. 

Underneath the corium of the mucous membrane there 
is the fibro-vascular layer, which contains the blood vessels, 
lymphatics and nerves and embedded in the epithelial cells 
supported by the corium are the numerous mucous glands 
or follicles. In some portions of the mucous tract and pro- 
jecting out of it are little elevations called villi or papillae, 
analogous to the papillae of the skin. 

(182) 



HYGIENIC MEASURES. 183 

These glands and papillae exist only at certain parts and 
are modified according to the function that the organ per- 
forms. The mucous glands of the stomach differ from those 
of the intestines, and those of the mouth from those of the 
bronchial tubes. The mucous membrane of the womb dif- 
fers from all the rest, by having no submucous or fibro- 
vascular layer ; the mucous glands of the womb are im- 
bedded and extend directly into the muscular tissue of the 
organ. The secreting glands, which form a special feature of 
mucous membranes, are abundantly supplied by small capil- 
lary blood vessels and nerves, so that any disturbance of the 
general or systemic circulation or a derangement of the 
nervous system will at once greatly influence the healthy or 
normal secretion of the membrane, just exactly as the skin 
is affected by cold or fright. 

In order to appreciate all the causes that operate for 
either good or evil, we must pause for a moment and con- 
sider the sympathy with and the close relation of the mucous 
membrane to the circulation of the blood and the nervous sys- 
tem. The mucous membrane of the different organs is often 
made the safety valve through which obnoxious materials 
or morbid conditions of the blood are eliminated from the 
system, and for that reason I have long ago discarded the 
usual harsh measures in the treatment of sudden or acute 
catarrhs. I have found that, by carefully watching and 
giving close attention to the details of certain rules of health, 
catarrhs speedily disappear of their own accord : on the 
other hand, if irritating local remedies are constantly used, 
catarrhs continue to grow worse. 

This demonstrated fact so very often repeated, impressed 
upon my mind the importance of hygienic measures for the 
successful treatment of catarrhal inflammations, whether 
they are of the respiratory organs or of the female pelvic or- 
gans. The most prominent and efficacious measures are to 
be found in intelligent precautions for preventing colds and 
inuring the system to changes of temperature by appropriate 
outdoor exercise. 



184 HOME TREATMENT. . 

By far the greater proportion of female complaints are 
catarrhal inflammations, and these fasten themselves upon 
all the pelvic organs — on the bladder, vagina, womb and 
Fallopian tubes. 

We generally know how we contract a bronchial catarrh 
or bronchitis, a nasal catarrh or sore throat ; in precisely the 
same manner do women contract most of their pelvic ca- 
tarrhs, that is, from a common cold or sudden chilling of 
the body or part of the body. 

Dr. Thomas F. Rumbold, in his work on the "Hygiene 
and Treatment of Catarrh," says : " The history of every case 
of chronic catarrh attests that the complaint commenced 
with colds in the head and that the disease grew upon the 
patient almost imperceptibly, the first colds being so trivial 
in character as to attract but little attention." 

This statement is as true of the great majority of cases of 
vaginal and uterine catarrh as it is of catarrhs of the air 
passages, and for this reason the measures and precautions 
for the prevention of colds must be one of the features in the 
successful treatment of female complaints. 

The particulars of the causation of colds and the hy- 
gienic precautions for their prevention are hardly ever given 
the attention which their importance demands in the treat- 
ment for catarrhal complaints of women, so that a great 
deal of suffering is left unrelieved and a great deal of ex- 
pensive and useless doctoring is endured. Altogether too 
much reliance is placed upon a wash or some local appli- 
cation made by the doctor to the affected parts, and, indeed, 
the mainspring of the catarrhal affection is entirely over- 
looked or neglected, which is, the susceptibility to the re- 
currence of fresh colds. 

The injurious effects of taking cold or chilling the body 
or any part of it, have been the subject of special inquiry in 
Germany. The mucous membrane and the skin seem the 
most sensitive to sudden changes from a warm to a colder 
atmosphere, but observations have already proven that be- 



HYGIENIC MEASURES. 185 

sides the usual catarrhal inflammations, there are other in- 
flammatory conditions that are developed. The kidneys, 
lungs, and liver have been found to be the seat of inflam- 
mations in a series of experiments that were made with rab- 
bits that were removed from a warm to a much colder 
apartment, and from this may be inferred that these condi- 
tions originate similarly in the human subject. 

The logical conclusions of these researches have been, 
that the chilled or cooled blood becomes chemically altered 
and acts as a direct irritant in the small capillary vessels, 
and by that means all the phenomena of inflammation of 
the tissues are excited, and these of course develop wherever 
the cold may strike or locate. 

When we speak of a slight or a bad cold, we cannot 
form the least idea of the remote effects that the cold may 
bring about. It may lay the foundation of a nephritis or 
Bright's disease of the kidneys, or some other lesion, and 
that it often gives rise to vaginal and uterine catarrh is as 
certain as that it gives rise to nasal catarrh or a cold in the 
head. 

An aptitude to take cold grows with each repetition of 
the attack and the prolonged duration of the acute catarrhal 
symptoms. And for that reason persons grow into the habit 
of taking cold upon the slightest exposure or change of 
temperature. At this stage of catarrh there is an abnormal 
sensitiveness of the mucous membrane and skin, in which 
the slightest draught of air or even passing from one room 
to another occasions an attack of sneezing or a chill and 
other symptoms that will indispose the patient for several 
days. 

The great majority of individuals have a natural predis- 
position to certain diseases. 

In anatomy the body has been divided into systems. A 
system is an assemblage of organs composed of the same 
tissues and intended for similar functions, as the circulatory 
system, the nervous system, the muscular system, the cuta- 



186 HOME TREATMENT. 

neous system, etc.; these systems are all liable to particular 
diseases. In one person the mucous membrane of the respi- 
ratory system is the most sensitive part of the body, while 
in another, and especially in women, it is the mucous mem- 
brane of the genito -urinary system. In other words, one 
person will take a cold and it will settle in the head or on 
the bronchial tubes, while another from the same exposure 
will get a catarrhal inflammation of the bladder or womb;: 
this is only explained on the theory of natural predisposi- 
tions, and, perhaps, hereditary taints. 

If a person once knows the weak or vulnerable points, 
he can outgrow them, by employing such rules of hygiene 
as experience has taught to be useful. There is much more 
benefit to be derived in an educational treatment directed 
to the prevention of disease, for this is also in the nature of 
a cure, than in a blind obedient faith in the treatment or 
remedy of a physician who may be ignorant, and generally 
is, of the laws of health or the science of hygiene. 

To promote health and to antagonize disease is greatly 
within one's own power, because there is no doubt that most 
diseases are the result of imprudence that cannot be attrib- 
uted to ignorance, because persons commit these errors with 
a full knowledge of their evil effects. 

A health}^ habitation, that has all the advantages of pure 
air and sunshine, is an essential feature in regaining health 
and encouraging a cure. There are hundreds of persons 
who have been sick and miserable for years, and who have 
made the rounds of all the doctors they ever heard of, with- 
out the least benefit to themselves, because they were never 
told how to live, and their living rooms are dark and sun- 
less and poorly ventilated. 

The even and equable temperature of all the rooms of a 
house should be kept in constant view, so that sudden and 
extreme changes of temperature are avoided. 

Warming a dwelling artificially should be one of the 
important features in the construction of a completely-fur- 






HYGIENIC MEASURES. 187 

nished residence. This subject has been neglected, owin^ 
to the temperate climate of California, yet the moisture of 
the air, and the closeness with which dwellings are built in 
cities, exclude the rays of the sun and make houses too cold 
for health and comfort. In our climate we become more 
sensitive to the cold air than those who live in drier regions. 

In shaded houses and rooms, especially in damp weather, 
we need artificial heating as much as they do in colder cli- 
mates, so that architects should make it a study to introduce 
a system of heating that will insure an equable temperature 
throughout the entire building, at a minimum of expense. 

The fireplace or open hearth, which has become so pop- 
ular with us as the pleasantest and healthiest mode of heat- 
ing and also insuring ventilation, should be discarded for 
something much better. The fact that the fire is directly 
beneath the chimney flue explains the fact that eighty-seven 
per cent of the total heat yielded by coal or coke and 
ninety-four per cent of that yielded by wood escapes through 
the chimney. This enormous loss of temperature arises from 
the current of air necessary for combustion, carrying with it 
a large quantity of the heat produced which is lost in the 
atmosphere. This of course is a means of ventilation, but a 
little reflection will convince almost anyone that it cannot 
be the most practical, and in this State where coal is very 
high it is equally expensive. The smoke, soot, and ashes 
that are inseparable from the open fireplace make it trouble- 
some and dirty, not to say anything of the coal gas, which 
poisons the atmosphere of a room, and I have often noticed 
its noxious influence on infants. 

There are objections against warming one or two rooms 
of a house and leaving the others cold. A warm sitting 
room, while the halls and bedrooms remain cold and chilly, 
is a very fruitful source of cold and catarrhs. 

There is a vast difference between heating for health, and 
heating to have warm rooms; in the former, the warm rooms 
would be incidental to health and comfort, while in the latter 
you might sacrifice health for warm rooms. 



188 HOME TREATMENT. 

Heating by hot air has serious objections that may be 
briefly stated as follows : Fresh air passing through or around 
red hot furnaces, becomes so rarefied that it no longer con- 
tains sufficient oxygen for healthful breathing purposes. 

The expansion and contraction of the furnace allows the 
escape of the noxious gases of combustion which become 
unavoidably mixed with the hot air that is to heat the 
dwelling, and thus vitiate the air that is to be breathed, and 
should there be any malaria from defective sewerage in the 
basement that, too, would be circulated with the heated air. 

It seems also to be impossible to distribute hot air equally 
to all the rooms of a house through long flues, for the hot air 
is choked off at the registers by the counter currents of cold 
air from the rooms on the side of the house exposed to the 
winds, while the protected side is always overheated. 

I have practically demonstrated, in my own residence, 
that hot water is the most simple and efficient means of heat- 
ing a dwelling for both health and comfort, and for several 
reasons: There is no danger of overheating, and there is no 
possibility of vitiating the air, because the temperature of 
the hot water is always lower than even the boiling point. 

With a proper distribution of the heated water through 
pipes, and radiators of sufficient heating surface, all rooms 
can be warmed to an equal temperature. Another consider- 
ation is the economy in fuel when properly constructed heat- 
ers are used, for the water readily absorbs the heat and re- 
tains it for hours after the fire has ceased to burn. Unlike 
steam heating, a moderate fire will warm the house in mod- 
erate weather. Hot water heating does not exclude a prac- 
tical scientific system of ventilation. There is no danger 
from explosion, nor from fire, the plant is absolutely odor- 
less and noiseless, and requires neither mechanical skill nor 
close attention to run it. There is no doubt of the durabil- 
ity of a hot water system, for if properly constructed it 
should last as long as the building, and the cost is less than 
a number of mantels with the necessary flues. 



HYGIENIC MEASURES. ISO 

The most comfortable average temperature for living 
rooms is from 65 to 70 degrees Fahr., for hospitals and sick 
rooms a higher temperature is generally required, say from 
75 to 80 degrees Fahr. 

Dr. Horace Dobell, of London, in his work entitled 
"Winter Cough," makes some very practical and useful re- 
marks, when he says: "But before leaving the subject of sud- 
den changes of temperature, I must not forget to speak of 
sleeping rooms. It is quite astonishing what follies are 
committed with regard to the temperature of sleeping rooms. 
On what possible ground people justify the sudden transi- 
tion from the hot sitting room to a wretched cold bedroom, 
which uislj not have had a fire in it for weeks or months, it 
is impossible to say, but it is quite certain that the absurd 
neglect of properly warming bedrooms, is a fruitful source 
of all forms of catarrh. We cannot too much impress this 
upon our patients." 

There is another source of danger in artificial heating, 
and that is, in having the air of the house always much 
warmer than the most favored temperature of the open air. 
This is a great mistake because it is under these circum- 
stances almost impossible to go from an overheated house 
or apartment into the open fresh air without catching cold, 
and for this reason the thermometer should be found in 
every well-regulated household. Women who are under 
treatment for female disease should never get into a cold 
bed, even if there has been fire in the sleeping room during 
the day. In damp and cold weather there should be greater 
precaution in this respect. The best bed warmer is one or 
more earthenware jugs, like the German seltzer water jugs, 
filled with hot water. Earthenware radiates the heat better 
and retains the warmth longer than glass, while there is no 
danger of the heat cracking the jug, as it will glass bottles. 
One or two of these jugs filled with hot water and put into a 
bed an hour or so before retiring will bring the temperature 
up to an agreeable warmth. 



190 HOME TREATMENT. 

Proper clothing is perhaps from a sanitary standpoint of 
equal importance with that of artificial heating and ventila- 
tion. With appropriate clothing, the body can be pro- 
tected against the inclemency of the weather and the sud- 
den changes of the atmosphere so that no ill effects are 
experienced from the great changes of temperature to which 
we are exposed. Women are dressed less warmly than 
men, although they do not possess the bodily strength to re- 
sist cold in the same degree as men. Their garments are 
not only made of lighter material, but the loose, fluttering 
manner in which they hang around the limbs does not pro- 
tect their bodies in the same thorough manner that similar 
material made after the style of men's clothing protects men. 

This does not imply that women should don men's cloth- 
ing, because the present costume or outside apparel of 
women of civilized countries, is both graceful and modest. 
A reform, however, in her underclothing is not only desir- 
able but in many cases absolutely necessary to insure per- 
manent relief from catarrhal affections. 

All women who are suffering from uterine or pelvic 
diseases, and who are still wedded to the injurious costume 
of open drawers and skirts, have an important lesson to learn. 

A warm and complete covering for the lower extremities 
and pelvic organs is paramount to any medicine or treatment 
that can be given. 

It is during the menstrual period that the pelvic organs 
are more susceptible to congestion and inflammation from 
exposures than at any other time, and from the manner in 
which women dress, it is surprising that there is not more 
sickness among them than there really is. Wide and open 
cotton drawers, and skirts hanging loosely around their limbs, 
with cotton hose, are no protection against drafts and sudden 
changes, so that it often happens that the extremities are 
chilled and cold, which is in itself sufficient to cause uterine 
diseases. When this exposure continues, with some already 
existing disease, it will neutralize the best-directed efforts to 
accomplish a cure. 



HYGIENIC MEASURES. 191 

It is said of the celebrated Boerhave, that among his 
effects there was a carefully-sealed prescription, which con- 
tained the secret for preserving health and vigor to a ripe old 
age. In his last will and testament it was provided that the 
prescription should be sold to the highest bidder at public 
auction. A physician who was anxious to procure the recipe 
of this renowned Dutch doctor, bought it for a very high price. 
On breaking the seal and anxiously unfolding the paper, 
he found these words: "Keep the head cool, the extremities 
warm, and the abdomen free." The buyer was greatly cha- 
grined at the simplicity of the supposed panacea, but, if the 
profession and the public only appreciated the real worth of 
the advice, there would be much less sickness. 

This strikes at most of the evils in dress that pave the 
way for diseases of women. It comprises the evil effects of 
tight lacing and compressing the abdominal organs by 
improper support for the skirts. A corset should never be 
worn so tight that the hand cannot be passed through the 
waist line. In the absence of a waist or shoulder straps for 
the support of the skirts from the shoulders, shoulder straps 
should be fastened directly to the corset, so as to relieve the 
hips and abdomen from the weight of the clothing. 

The corset waist is not only a perfect substitute for a 
corset, in supporting the bosom and preserving the form so 
as to give a handsome figure, but it supports the skirts with- 
out restricting the circulation and respiration, or compressing 
the abdominal organs. In buying or making a waist or 
bodice, particular attention must be paid to the shoulder- 
bands, so that these bands are short enough to give the waist 
or bodice support from the shoulders. If, then, the skirts 
are buttoned to the waist, the weight is taken from the hips, 
where it injuriously depresses the abdominal 'organs, and 
falls on the shoulders, where it cannot do any harm. There 
is a good deal of humbuggery about these new devices, and 
those who make it a business to sell them, never take the 
pains, or are incompetent, to properly fit the waist. If one 



192 HOME TREATMENT. 

only bears in mind that, if the waist does not support the 
skirts from the shoulders, there is nothing gained over wear- 
ing an old-style corset, imposition is impossible. 

The dressing for the feet should be warm and comforta- 
ble. Women who go to balls and parties should always 
wear overshoes in going to and coming from an enter- 
tainment. Thin and light shoes must be avoided in cold 
and damp weather; in fact, there is nothing that women 
should be more careful about than too light and low shoes 
which do not keep the feet warm. For comfort and keep- 
ing the feet warm, there is nothing like a loosely-fitting 
leather shoe, with wide and thick soles, and a low, flat, En- 
glish heel. It is also the best "corn remedy" I know of. 

When the weather is wet and cold, rubber overshoes 
should be worn, and these should be removed when enter- 
ing the house. Women who have a tendency to cold 
feet, will find the cork or felt soles worn inside of the shoes, 
a great source of warmth and comfort. The coldest stratum 
of air is invariably on the floor of the room, and there is, 
perhaps, no easier or more unsuspected way to take a cold 
than to exchange a pair of high, warm shoes that fit closely 
around the ankles, for a pair of light, low slippers. If you 
desire to rest your feet in a pair of light slippers, then add 
a pair of heavy woolen socks over the stockings, this will 
greatly lessen the chances of taking cold. 

Women who are suffering from pelvic or womb diseases, 
and who are anxious to get well, and those who are troubled 
with painful menstruation, and menstrual irregularities, 
should wear woolen hose. Thin cotton, silk-mixed, or silk 
hose are not sufficiently warm, nor do they retain the nat- 
ural heat of the body like woolen stockings. 

Those who have once accustomed themselves to woolen 
hose, should not discard them in the summer months for 
cotton, linen or silk goods, and this is to be particularly ob- 
served on this coast, but the hose should be exchanged for 
thinner and lighter goods of the same material, correspond- 
ing to the demands of the season. It would not be wise or 



HYGIENIC MEASURES. 193 

prudent to wear the same quality and amount of clothing in 
warm weather as in cold ; otherwise the excessive clothing 
in the summer months will induce perspiration on the 
slightest exertion, and thus the system becomes most sus- 
ceptible to cold when the weather changes or becomes cooler. 

Elastic garters to maintain the tops of the stockings in 
position should be avoided. Rubber bands make a contin- 
uous compression on the vessels and nerves, although al- 
most every woman claims that she does not wear her gar- 
ters tight, yet at night when she removes the elastics there 
are deep furrows marking the constriction of the garters. 
The spring-wire garters are just as injurious, for they also 
exert a continuous pressure. 

The veins of the legs are, for the most part, superficial, 
and this steady and gradual compression is very injurious 
to the venous circulation, so that the blood is prevented 
from returning from the limbs as readily as it should ; this 
induces cold feet, and when the circulation is already weak, 
it often imparts a feeling of heaviness to the limbs, for 
which women doctor but without getting any relief. The 
only proper support for the hose is elastic straps that are 
supported from the waist; they are now so well known and 
for sale in every dry goods store that a description of them is 
unnecessary. 

To keep the legs and body warm is not a question of 
quality or quantity of skirts or wraps. If the limbs under 
them 'are not separately enveloped and are only covered with 
thin cotton or silk hose and open cotton drawers, women are 
continuously exposed to the cold, damp emanations from the 
ground and to the drafts caused by the motion of the skirts, 
and blasts of wind. 

The most intelligent suggestions for Dress Reform are 
those that are directed towards reducing the weight or dis- 
placing the heavy, stiff, and unwieldy skirts and clothing 
the extremities of the female in divided garments, so that 
they are no longer exposed to the dangers of cold and drafts. 
The divided skirt is in the direct line of a modest and desir- 
13 



194 HOME TREATMENT. 

able improvement of woman's dress, and it is growing in 
popularity among the most intelligent of reading and think- 
ing women. If the specialists of female diseases were to study 
the interests of their patieuts with the same ardor that they 
study the methods how best to fill their offices with patients, 
on whom they perform useless and dangerous operations, 
they would be of some actual benefit to our wives, mothers, 
and sisters, and our women could be dressed as gracefully 
as at present with less than half the underclothes to pack 
around with them. 

I am decidedly opposed to anything approaching in style 
or shape the bloomer costume; the present style of outside 
dress cannot possibly be improved for a comely garment, 
but it is underneath this that an entire change should be 
speedily effected. The divided skirt is cut like drawers that 
have a width of thirty to forty inches of goods in each leg. 
I believe that the width of each leg should not be more 
than twenty-five to thirty inches; this makes the skirt 
warmer and lighter. This is not attached to a band to 
fasten around the waist, but to a yoke, which should be but- 
toned to the bodice waist, suspending the skirt from the 
shoulders. The material will be a matter of individual 
taste; the two qualities that should be always looked for are 
softness and warmth, and for that reason Jersey flannel and 
ladies' cloth are the most suitable material ; in summer or 
warm climates, pongee or wash silks may be substituted. 

The skirt is cut on the bias to fit the hips, where it is 
fulled in and attached to a yoke instead of a band and in 
the back it laps about two or three inches. The advantage 
of the divided skirt is that it protects the limbs and body 
against drafts and cold emanations, and takes the place of 
all underskirts and petticoats. This skirt alone, however, 
would be insufficient to accomplish all that is desired by 
way of guarding against exposures; for this reason there is 
also a so-called Union suit worn under the divided skirt to 
complete the covering of the limbs. 

Union suits, as the name implies, unite a pair of closely- 



HYGIENIC MEASURES. 195 

fitting drawers with an undershirt. There is no particular 
advantage in uniting the underdrawers with the undershirt, 
but there is certainly no disadvantage. The principal ob- 
ject that is to be attained is not in unionizing drawers and 
shirts, but wearing such closely-fitting undergarments that the 
extremities are permanently protected, and in having them 
so lapped or closed that the abdomen and pelvic organs are 
securely protected against cold. 

Equestrian tights are made on the same principle and 
for a similar purpose as union suits, namely, to properly 
and surely cover the limbs and in a measure displace the 
great load of petticoats that women usually wear. They 
come in drawers and also in combination suits with the un- 
dershirts; a choice may be left to individual taste. There 
are different brands of these goods on sale in all the dry 
goods stores of our large cities, the prices being regulated by 
material and quality of the goods from which they are 
made. The woolen goods are preferable for practical 
purposes. 

Women who do not like the woven closely-fitting drawers 
can take their choice between the latter and home-made 
flannel drawers, the French flannel for the lighter and the 
English bully for heavier and warmer clothing will be 
found to be the most serviceable materials; patterns for 
making up closed or button drawers may be had at the 
leading pattern stores of any city. 

Women who cannot grow up to an appreciation of the 
divided skirt should by all means wear equestrian tights or 
buttoned flannel drawers, under cotton or linen ones ; this 
will enable them to throw off one or two petticoats or skirts 
because the drawers will safely substitute the skirts and be 
much lighter. Some women dread the absence of skirts on 
account of appearing too scant; a little extra fullness and 
drapery to the dress make the absence of skirts not notice- 
able. If this were not quite so, there appears no satisfac- 
tory reason why a woman should feel embarrassed to mod- 
estly display the contour of her form any less than a man. 



CHAPTER XV. 

METRITIS OR INFLAMMATION OF THE WOMB. 

This is an inflammation of the entire substance of the 
womb, which, like all inflammatory processes, is acute or 
chronic. 

Inflammation does not always affect the whole body of 
the womb, but it is quite oftener limited to one or the other 
layer or membrane that enters into its architectural whole- 
Then, again, there is the anatomical division of the organ 
into a body or corpus, and a neck or cervix; of these either 
one may be affected, without the other, so that inflammation 
of the cervix should be the subject of a separate inquiry. 

Most of the diseases of the womb are due to inflamma- 
tion. This was the opinion of J. H. Bennett, of London, as 
long ago as 1845, in which year the first edition of his work 
on "Inflammation of the Uterus" was published. Up to 
that time, the subject had never been practically pursued to 
the same logical conclusions, so that the opinions of the 
leading professional minds were far from unanimous on 
this question. But the vigor and energy with which the 
young author defended his views, forced attention and con- 
viction upon the greater part of the profession, in this coun- 
try and Europe. 

He started out with a view to prove: "1. That inflam- 
mation is the primum mobile in uterine affections, and that 
from it follow, as results, displacements, ulcerations and af- 
fections of the appendages. 2. That menstrual troubles and 
leucorrhoea are merely symptoms of this morbid state. 3. 
That in the vast majority of cases, inflammatory action will 
be found to confine itself to the cervical canal and not to- 
affect the cavity of the body." 
(196) 



INFLAMMATION OF THE WOMB. 197 

Since the appearance of the first edition of Dr. Bennett's 
work, which is now forty-six years ago, there have been 
many careful and clever observers in this field of pathology, 
but there is yet to appear a successful contradiction of the 
truth of his inflammatory doctrine. Twenty-six years after 
Dr. Bennett wrote the above book, he read a paper before 
the British Medical Association on the same subject, in 
which there is no modification of his first conclusions on 
the importance of inflammatory lesions. He says: "1. Uter- 
ine displacements are by many too much studied per se (by 
themselves) independently of the inflammatory diseases that 
complicate and often occasion them. 2. That the exami- 
nations made to ascertain the existence of inflammatory com- 
plications are often not made with sufficient care and mi- 
nuteness, as evidenced by the fact that I constantly see in 
practice cases in which inflammatory processes have been 
entirely neglected, and the secondary displacements alone 
treated. 3. That inflammatory lesions are often the princi- 
pal cause of the uterine displacements through the enlarge- 
ment and increased weight of the womb, or a portion of its 
tissues, which they occasion. 4. That when such inflam- 
matory conditions exist, as a rule they should be treated 
and cured and then time given to nature to absorb morbid 
enlargements before mechanical and surgical measures are 
resorted to." 

If these propositions could be engrossed and a copy sent 
to every doctor in the land, as a safe and sure guide in his 
treatment of diseases of women, it would prove a great boon 
to the suffering women of this country. One of the notori- 
ous abuses of the profession, is the penchant for the employ- 
ment of mechanical means, either by means of instruments 
or the surgeon's knife. Women are wantonly subjected to 
painful and tedious treatments which in many cases only 
aggravate their original suffering, while a few simple rules 
of hygienic treatment would not only restore them to health 
and vigor, but would save them the privation of paying fees 



198 HOME TREATMENT. 

to incompetent, unscrupulous or avaricious doctors, who 
have only one ambition, that is, to get the patient's money. 
I have known an instance where this barbarous course under 
the guise of scientific treatment, broke up the home of a once 
happy and prosperous couple, and finally when the resources 
were so low that the expense incident to housekeeping and a 
nurse could no longer be defrayed, the household effects- 
were disposed of, and, as a last resort, the overdoctored 
woman was taken to a hospital, where her last hopes were 
lulled into an artificial sleep, while the surgeons performed 
an operation from which her depleted body and squandered 
vitality could never recover. She died. 

I am convinced from observations in large female clinics 
in Berlin, and from my own studies in the pathological 
laboratory while a student abroad, that Dr. Bennett's con- 
clusions are corroborated by actual facts. The freedom with 
which dangerous operations are undertaken for compara- 
tively trivial complaints is degenerating into a license that 
is criminal and which in some cases is nothing less than 
murder. In the absence of a high moral sentiment which 
should control the profession, but does not, the State must step 
in and say who shall practice medicine and surgery, and by 
limiting competition, the evil propensity to make the most 
of one's opportunities will not be elevated into a fine art, and 
men, although unscrupulous, may be at least indifferent 
honest. 

Acute metritis comes on suddenly, and this occurs quite 
often during the menstrual period. Women as a rule are 
altogether too careless during menstruation; they seem to 
forget that at this time the womb is congested and swollen, 
and that if the natural flow of the blood is interfered with, 
this congestion will turn into an inflammation. Exposure 
to cold, or getting the feet damp, or inordinate exercise 
that overheats the system, will bring this about. Some- 
times there may be a tumor or swelling in the womb which 
occludes the cervical canal, so that the menstrual fluid can- 



INFLAMMATION OF THE WOMB. 109 

not escape; this will also cause inflammation. A stricture 
of the cervical canal, occasioned by the womb being flexed, 
will interfere with the egress of the menstrual flow, and this 
also may give rise to inflammation. Vaginal injections 
either too hot or too cold, and particularly immediately 
after copulation, when the pelvic organs are still in a high 
state of congestion, is quite liable to excite metritis. Gonor- 
rheal infection is another source of inflammation, but this 
is invariably preceded by an endometritis, which I will con- 
sider separately. 

Large, ill-fitting pessaries worn in the vagina for a sup- 
posed retroflected or prolapsed uterus, or a stem pessary, are 
fruitful causes of metritis. 

Other causes are criminal abortion, complicated with 
blood poisoning from the unclean probes or instruments, that 
the abortionist has employed on previous operations with- 
out thoroughly cleansing and disinfecting them ; the appli- 
cation of strong caustics to the cervix of the womb, as well 
as injections into the cavity of the uterus. Meddlesome doc- 
toring by means of the unskillful and unnecessary use of in- 
struments, like the probing of the womb without proper an- 
tiseptic precautions, or the scraping, stretching or operating 
on the womb without the essential antiseptic precautions 
which a scientific comprehension of the subject demands, 
has frequently caused this affection. 

It occurs very often as a part of the general inflamma- 
tion produced by the absorption of putrid or septic matter 
during the childbed period. This indicates a lack of clean- 
liness on the part of the attendants during confinement; in- 
flammations of this nature constitute one of the types of 
puerperal or childbed fever. ' 

The most prominent symptom is pain. This is greatly 
aggravated on the slightest pressure, or on moving or turn- 
ing in bed. Upon a digital examination, the womb is found 
enlarged or swollen, and when the organ is tilted up on the 
examiner's finger, there is a sharp lancinating pain radia- 
ting from it in all directions. . . . 



200 - HOME TREATMENT. 

The first symptoms of pain are always accompanied with 
fever, and this may have been ushered in or alternated with 
a chill. The pain may be first felt rather deeply in the pel- 
vis, and this is increased by a frequent desire to pass urine 
and a straining of the rectum. It may further become com- 
plicated with a looseness of the bowels, or an obstinate con- 
stipation. Nausea and vomiting is a frequent symptom dur- 
ing the course of the disease, and if the metritis is developed 
during menstruation, the flow may suddenly stop, but, on 
the other hand, the hemorrhage may become alarmingly 
profuse. Standing, walking, coughing and straining at 
stool excite the most excruciating pain, so that a recumbent 
quiet position is the only comfortable way for the patient to 
maintain herself, with the head as low as possible to insure 
the most easy recumbency. 

The treatment for acute metritis depends somewhat on 
the cause in each individual case. There are, however, two 
indications that require to be met, and these are common to 
all inflammations, namely, to relieve the pain and check the 
inflammatory process. 

The former is quickly relieved by introducing into the 
vagina a Femina vaginal capsule in the usual manner; 
repeating every six to eight hours, until the pain is sufli- 
ciently alleviated to occasion no suffering; then one capsule 
should be employed every night until cured or until restless- 
ness requires that something must be done to calm the 
patient. 

If the metritis is due to suppressed or checked menstrua- 
tion from cold or exposure, then, and only then, are hot 
fomentations over the entire abdomen the most appropriate 
application, and if the patient is plethoric, I advise a half- 
dozen leeches to the inguinal region of one or both sides to 
be of unequaled value for checking the disease. 

Until my experience and observation in German hos- 
pitals, I was in the habit of employing hot applications for 
all acute inflammations of the abdominal organs. These 
were either in the form of hot-water fomentations or flax- 



INFLAMMATION OF THE WOMB. 201 

seed poultices. Hot applications undoubtedly give relief, 
but I doubt whether they ever cut short or abridge the in- 
flammatory process in any case. I am inclined to believe 
that in a great many instances hot fomentations have the 
tendency to encourage suppuration, and that an abscess is 
often the result of their use. I have seen decidedly better 
results from cold applications, and the colder the better, so 
that I now employ them universally in all acute inflamma- 
tions of the pelvic organs except in the noted exception in 
which the inflammation is due to a sudden check of the 
menses from exposure. As a preventive of inflammations, 
after delicate operations on the uterus, I apply the rubber ice 
bag with invariable success. 

The most suitable rubber bag for this purpose is a size 
of six by twelve inches ; it should be filled with broken pieces, 
and then securely tied. I prefer to envelop the bag in a 
thin layer of flannel, so as to take off the cold, clammy sen- 
sation which the rubber imparts to the skin. There should 
be two of these bags, in case of accidentally tearing one, and 
so that the reserved one may be in readiness when the other 
is removed. The cold does not only check and control the 
inflammation, but it also benumbs the nerves, so that it greatly 
relieves pain. I keep these ice bags applied over the region 
of the womb, until all the acute symptoms disappear. The 
vagina, however, should be irrigated with medium hot borax 
water, once a day, so as to remove any irritating discharge 
from the uterine cavity. 

The digestive derangements that so often accompany 
acute metritis; the nausea and vomiting of this and kin- 
dred diseases, are alleviated by this formula : — 

NO. IX. 

Take: Subcarbonate of bismuth 2 drams 

Bicarbonate of sodium 2 drams 

Tr. of opium, deodorized 2 drams 

Tr. of nux vomica 1 dram 

Simple syrup 1 ounce 

Peppermint water, sufficient to make 6 ounces 



202 HOME TREATMENT.', 

Mix, and take a tablespoonful every one or two hours, 
until relieved; to allay the thirst and dryness, take small 
pieces of ice. Constipation of the bowels should be relieved 
by taking a Femina laxative tablet every six hours until the 
stools are freely moved ; after that one should be taken every 
night or perhaps every other night, so as to keep the system 
regulated. 

Some persons suffer from costiveness because they do not 
drink enough water, and when taking medicines to correct 
this disorder it is always well to drink a large tumblerful of 
water at the same time, and especially at bedtime, three or 
more hours after supper, and early in the morning is another 
good time for drinking water and taking a laxative. 



CHAPTER XVI. 

CHRONIC METRITIS OR CHRONIC INFLAMMATION 
OF THE WOMB. 

When from neglected or improper treatment, the acute 
inflammation is not checked, so as to restore the organ to its 
normal condition, the inflammatory process assumes a 
chronic character. As inflammation is an abnormal vital 
activity, which results in the proliferation or building up of 
fibrous tissue, it must be naturally inferred that if the in- 
flammatory process is active in an organ for a considerable 
length of time, the tissues of this organ must grow or in- 
crease, so as to augment its size and weight. This is in- 
deed so, hence the other names that have been given to this 
disease to distinguish it from the acute or transient form, all 
imply tissue growth, as hypergenesis of the connective tissue, 
engorgement or inflammatory hypertrophy of the uterus. 

The entire organ may be thus affected, or it may be lim- 
ited to either one or the other anatomical divisions of the 
uterus, namely, the body or the neck. 

Of all the different varieties of chronic inflammation 
of the womb, that of the neck or cervix is the most fre- 
quently met. This is due to the fact that in married women 
and those who have born children the cervix of the womb 
is exposed to mechanical injury from coition, friction against 
the vaginal walls in walking and from lacerations during 
delivery. 

The body of the womb is further removed from all these 
mechanical agencies to which the cervix is exposed, for the 
body is within the abdomen of the female, and for that rea- 
son it is less liable to be injuriously affected by influences 
that cause inflammatory enlargement. But notwithstand- 
ing all this, it is a common disease. 

(203) 



204 HOME TREATMENT. 

A great many cases of womb complaint that do not 
yield to ordinary treatment are really of this nature, but 
owing to carelessness or incompetency are never recognized. 
The symptoms of this disease, which are obstinate leucorrhcea, 
falling of the womb or displacements, are mistaken and 
treated for the disease itself. Women who suffer with this 
complaint are extremely liable to go on for quite a while 
feeling comparatively well and in hopes that they are recov- 
ering, when some extra exertion or exposure to cold brings 
on a relapse, which lights up an acute inflammatory process. 
This passes into the old troublesome disease and this re- 
sumes its chronic form. After a repetition of the general 
routine treatment, the patient may again live under the de- 
lusion that she is going to get well only to have her hopes 
blasted by a sudden reappearance of the former painful 
symptoms, that are alike discouraging to herself and a 
puzzle to her friends. 

The cause of inflammatory enlargement of the uterus is 
usually connected with parturition or abortion. 

There never can be either the one or the other without 
more or less vascular activity, which is essential to the repair 
of the womb and its restoration to its physiological or 
healthy condition. All the uterine tissues are at this time 
in a high state of irritability, and if there is a natural pre- 
disposition to inflammatory diseases, then the slightest ob- 
stacle to an uninterrupted recovery will kindle an inflam- 
matory action, that will fasten itself on the uterus. In the 
very nature of things this results in a deposition of inflam- 
matory material, with a consequent increase of intermuscu- 
lar fibrous tissue which increases the size and weight of the 
uterus. 

What our mothers xermed in former days "a bad get- 
ting up," that is, when women get up from their confine- 
ment weakly and with more or less pain and dragging in 
the pelvis on walking or the slightest exertion, is generally 
owing to the above-described condition. This disease is 



CHRONIC METRITIS. 205 

now almost as common as ever. I can always trace these 
cases to a confinement or an abortion. 

It is very rare that it is due to a depreciation of vital 
forces from improper food, over-exertion, a prolonged nerv- 
ous depression or a constitutional tendency to tubercle, 
scrofula or some other hereditary diathesis, although these 
undoubtedly predispose the patient to the disease. 

Abortions stand at the head of all the causes that excite 
this affection. When the uterus is pregnant and its natural 
growth is abruptly checked by the destruction of the em- 
bryo, then the organ becomes at once the seat of a conges- 
tion and great vascular activity, for the purpose of repairing 
the injury that the premature expulsion of the embryo or 
fetus inflicted. 

If this congestion is delayed from improper care or treat- 
ment which fails to recognize the important fact that an 
abortion or interruption of pregnancy is a much greater 
shock to the system than a delivery at full term, it must 
result in arrested involution or permanent inflammatory 
enlargement. This most persons fail to appreciate, and, as 
a result, they do not take the same precautions that they 
would after the delivery of a living or fully-developed child. 

I am well aware that criminal abortionists are in the 
habit of deceiving their patrons by assuring them that there 
is no danger or bad results to be feared from their criminal 
operations. This is a vicious falsehood, and, coupled with the 
statement that there is as yet no living being in the womb, 
the crime of manslaughter is added to that of malpractice. 
In every case of abortion, whether accidental or criminal, 
the same care and attention must be given to the woman 
as during any natural lying-in period. 

There is a class of chronic inflammations that I have 
noticed in women who have always suffered from painful 
menstruations or from excessive or prolonged hemorrhage 
at the regular monthly period. This is complicated with 
some ovarian disease, which yields, however, to appropriate 
treatment. 






206 HOME TKEATMENT. 

There is quite a series of symptoms that denote the ex- 
istence of chronic metritis; these are not all present in each 
particular case but quite enough of them to diagnose the 
disease. Some of these symptoms are in the nature of com- 
plications, which in themselves may be mistaken for an indi- 
vidual disease, but upon a careful inquiry they can be 
traced directly to a chronic metritis, which if removed dis- 
poses of all the lesser ailments. 

The following are the most noted signs of this affection : 
painful copulation, and pain on defacation ; a dull, heavy, 
dragging pain through the pelvis, much increased by walk- 
ing; during menstruation the mammae are sensitive or 
painful; several days before the approach of the menses 
there is a dull pain, which lasts during the menstrual flow ; 
around the nipples, there is pigmentration or darkening ; 
sometimes nausea and vomiting, and dyspepsia, headache, 
and languor; pressure on the rectum with tenesmus and 
hemorrhoids ; leucorrhoea from catarrh of the womb; pressure 
on the bladder with tenesmus or straining. 

This disease may continue for years uninterruptedly, 
and, if there is not a cure accomplished, or successful meas- 
ures for its relief are not employed, it will continue until the 
menopause, or change of life, which may effect a sponta- 
neous cure. 

The enlargement is most noticeable in the cervix or neck. 
This is sometimes so great as to extend one or two inches 
into the vagina, and this condition is often mistaken for 
falling of the womb or prolapse, which is far from a correct 
diagnosis. A growing of the womb from chronic inflam- 
mation is the proper explanation. 

The hygienic suggestions given in a former chapter, 
form an important auxiliary in the treatment of this com- 
plaint, and for that reason it should be carefully studied. 

The treatment of chronic metritis has been, up to within 
a very recent period, anything but satisfactory in its results. 
This was, owing to an inadequate knowledge of the real 
nature of the disease, which was marked by so many symp- 



CHRONIC METRITIS. 207 

toms that were in themselves obscure and hard to separate 
as such, from the main affection. 

This confusion of the true nature of the pathological proc- 
ess, resulted in a great many vague therapeutical resources, 
so that the treatment is even yet far from uniform and thor- 
ough. Many of the recognized resources laid down in the 
text-books, on diseases of women, are not only useless, but 
absolutely injurious, and, in order to save the reader time 
and money, I will make a brief mention of the most promi- 
nent of them. 

Depletion, or the abstraction of blood in chronic metritis, 
effects no permanent benefit in the inflammatory process. I 
am convinced that, in the long run, the patients grow worse, 
because this treatment lowers the vitality and reduces the 
recuperative forces, which are so important, in the treatment 
of all chronic complaints. 

Scarifications or puncturing the cervix with a sharp 
lance or pointed knife, will not sufficiently impress the 
morbid process, so as to stimulate it into a healthy action. 

Some authors speak very highly of cauterizations and 
blisters upon the neck or lips of the womb ; this I have re- 
peatedly tried, and in not a single instance was it of the 
slightest use, but it aggravated the symptoms, and in one 
case it excited a severe, acute metritis that proved almost fatal. 

Specialists, as a rule, fall into routine practice, and exer- 
cise neither originality or intelligence in practice, outside of 
the text-book on their shelf. They inject strong fluids or 
caustics into the cavity of the womb with a view of checking 
the inflammation in that manner. This treatment is dan- 
gerous and delusive. If the patient endures the treatment, 
she may be stimulated for a time with the idea that some- 
thing very curative is being done, but my experience has 
been that the disease only becomes worse, because the womb 
is too delicate and sensitive an organ to improve under these 
repeated irritating assaults. 

There is a home treatment for mild cases which I recom- 
mend to my patients, with satisfactory results. It consists 



208 HOME TREATMENT. 

principally of dissolving one teaspoonful of the Femina 
uterine lotion in a cupful of boiling hot water, after which 
this should be added to a gallon of warm water of a tem- 
perature of 105 degrees F.; these irrigations are to be taken 
every night, and if the water can be borne hotter the tem- 
perature may be gradually increased to 107 degrees F. A 
napkin should be worn and the bed warmed with a hot wa- 
ter bag before retiring. Ten to fifteen minutes later a 
Femina vaginal capsule is to be introduced high up into the 
vagina, by first quickly dipping the capsule into warm 
water. 

In obstinate cases I have used electricity with the great- 
est success. This is administered by means of a broad dis- 
persing electrode applied on the abdomen, and another 
electrode, covered with a sponge, is carried up the vagina, to 
the womb. In this manner I employ an intensity of sixty 
to one hundred and fifty milliamperes, for ten to fifteen 
minutes. This is repeated several times a week, and from 
three to six weeks, and with other hygienic treatment the 
patient recovers. 

When women are in moderate circumstances, and can 
spare neither time nor money to visit the office, for the 
length of time that is required for the electrical treatment, I 
follow the plan of the Berlin clinic, which originated in 
Vienna, with Prof. Carl Braun, and is strongly recom- 
mended and practiced by Dr. Martin, in Berlin. This con- 
sists in an amputation of the cervix, or, in other words, the 
abnormally elongated and enlarged uterus is trimmed down, 
and the diseased membrane is scraped out. While the 
cervix is recovering from the operation, there is also a dim- 
inution in the size of the body of the organ, and the 
chronic inflammation subsides with it. This operation is 
not dangerous to life, and in my experience I have as yet 
never had a bad symptom to interrupt the recovery. In ob- 
stinate cases, it is, perhaps, one of the most useful surgical 
measures that was ever devised, and we owe it to the genius 
of Professor Braun, that all obstinate cases of this nature are 
amenable to successful treatment. 






CHAPTER XVII. 

ENDOMETRITIS OR CATARRHAL INFLAMMATION 
OF THE WOMB. 

Endo means within, and metritis signifies womb and in- 
flammation, and when all are combined, the compound term 
denotes imflammation of the lining membrane of the womb, 
which is the affection that I am now to consider. 

It would be impossible to find a single person of middle 
age who has not experienced sometime during life the dis- 
comforts of a catarrh or cold of some part of the respiratory 
passages, whether in the head or bronchial tubes. 

The mucous membranes are especially sensitive to nox- 
ious influences, and sound a timely note of warning by an 
acute catarrh, which, if heeded, will in many instances save 
the person from a dangerous, if not fatal sickness. 

The adage, "Prevention is better than cure," is one of 
the most truthful sayings in the English language, and, if 
persons would profit from the admonitions of a " slight cold" 
many a fatal pneumonia or bronchitis could be averted. 

What is true of the mucous membrane that is common 
to both sexes is true of that which is peculiar to the female 
organs alone. 

There is no mucous membrane that is more liable to 
catarrhal inflammations than that lining the uterus. 
There never was a woman who was not some time in her 
life afflicted with a transient uterine catarrh. It may have 
been of so mild a form that the symptoms which it occa- 
sioned were hardly noticed, or, perhaps, ascribed to some 
other ailment. 

There are several varieties of endometritis ; some of these 
are based upon the length of time that the affection has 
14 (209) 



210 HOME TREATMENT. 

lasted, while others owe their classification to the anatomical 
division of the uterus into body and cervix. Those that re- 
late to the duration of the disease are either acute or chronic. 

Acute endometritis is the most common form; it has also 
been described under the names of acute uterine leucor- 
rhoea, acute uterine catarrh, and acute internal metritis. It 
usually runs a rapid course, ending in recovery or in the 
chronic form. It undoubtedly passes unrecognized in many 
instances, and in this way many cases of painful menstrua- 
tion or suppressed menstruation are explainable. 

It can be said that at each and every menstrual period 
there is a physiological catarrh, which belongs to the natural 
process of the menstrual function. During each menstrua- 
tion there is a hyperemia, or congestion of the mucous 
membrane, so that the turgent blood vessels rupture, and 
this constitutes the menstrual flow. Before this congestion 
reaches the point of bursting the capillaries, and about the 
time that the sanguineous flow ceases, there is an increased 
and altered mucous secretion of the mucous membrane. If 
this secretion is prolonged beyond the normal period that 
constitutes healthy menstruation, or if it continues to be 
present at any time between the menstrual periods, it con- 
stitutes a disease or a catarrh. Now when we consider the 
close relation that the normal functions of the womb have 
to those that are abnormal, and that the one may be the 
stepping-stone to the other, we need not be surprised that 
endometritis, or catarrh of the womb, is one of the most com- 
mon affections to which women are liable. 

Chronic endometritis is where the disease has lasted for 
a long time; some authorities consider it a rare affection, 
but this is a great error. Any disease so frequent as acute 
endometritis must, in the very nature of inflammatory proc- 
esses, become chronic, in a large proportion of cases. 

Endometritis of the body of the womb, in contra-dis- 
tinction to a partial inflammation, located and confined to 
the mucous membrane of the neck or cervix of the womb, 



ENDOMETRITIS. 2 1 1 

forms another or third variety of this affeetion. This disease 
has been described under the names of chronic corporeal 
endometritis, uterine catarrh, uterine leucorrhcea, and inter- 
nal metritis, and the seat of it is confined to the lining mem- 
brane of the cavity of the womb, without complicating the 
cavity of the cervix ; but there is no doubt that when either 
the one or the other is the seat of a stubborn catarrh, the 
remaining portion of the uterus must become sooner or later 
more or less compromised in the diseased process. 

Chronic cervical endometritis is where the inflammation 
affects the membrane of the neck ; this has been described 
under the names of cervical catarrh, cervical leucorrhcea, and 
endocervicitis. These terms are all derived in composition 
from the Latin word cervix, neck. 

The uterus is really divided into two cavities that run 
into each other ; one of these is the cavity of the body, while 
the other is the cavity of the cervix, a fusiform canal, meas- 
uring about one inch and a quarter in length. The cervix 
partly projects into the vagina, and, as a result, is liable to 
injury and irritation, to which the other portion of the organ 
is not exposed. Friction and other influences aggravate the 
inflammatory process, so that erosions, granular and cystic 
degenerations, follicular ulcers and chronic enlargements, 
become complications of the catarrhal inflammation of the 
cervix. 

To return again to a consideration of the general aspect 
of catarrh of the womb, for it is one and the same patholog- 
ical process that underlies the different forms. There is a 
simplicity in the relation of cause and effect, that will strike 
the casual student as one of the most instructive lessons 
that it is possible to learn, because it also suggests the sim- 
plicity of the measures of which persons can avail themselves 
for the prevention or cure of this affection. 

From the physiological reasons that were mentioned as 
a cause of endometritis, it follows, as a natural consequence, 
that the predisposition to catarrh of the womb, varies greatly 



212 HOME TREATMENT. 

with the age of persons, so that before the age of puberty, 
at a time when there are no periodical congestions of the 
womb from the menses, it occurs very rarely, while from the 
period of pubescence, and during the functional activity of 
the pelvic organs, it is very prevalent, but at the approach 
of the menopause and sexual decadence the predisposition 
is again lost. 

As far as the character and nature of uterine catarrh is 
concerned, that which in technical language is termed the 
pathological anatomy is no different from what it is in catarrhal 
inflammations in other organs, so that the remarks that were 
made on similar affections of other organs, apply with equal 
correctness to catarrh of the uterus. 

There is, however, one exception of which I desire to re- 
mind the reader, and that is a hemorrhagic or granular 
variety of inflammation. In this form of the disease the 
mucous glands, and the blood vessels that are distributed 
between these glandular tubules, increase or multiply enor- 
mously, so that I have seen the mucous membrane in some 
places a quarter of an inch in thickness. This is the most 
obstinate variety to yield to ordinary remedies, and as it oc- 
casions excessive and at times dangerous hemorrhage from 
the womb, it should not be treated as conservatively as the 
other varieties df which I have spoken. 

There is only one sure method of cure that proved in my 
hands a success, and that consists in the entire removal of 
the diseased mucous surface. 

Dr. Diivelius of Berlin made the discovery and demon- 
strated the fact that the mucous glands of the uterus pro- 
ject into the muscular tissue of the organ, and that if the 
diseased mucous membrane is removed or scraped off, down 
to the muscular layer, a healthy membrane is regener- 
ated from the terminal glandular ends that remain im- 
bedded in the muscular tissue. This seems to have been 
proved by experience, for I have performed this operation 
in several obstinate cases of uterine catarrh, and in several 



ENDOMETKITIS. 213 

instances the woman became subsequently pregnant, which 
proves at least that the regenerated mucous membrane is 
capable of performing its physiological function, as though 
it never had been interfered with. With proper antiseptic 
precautions and in skillful hands, there is absolutely no 
danger in this operation, but the technique should be thor- 
oughly understood by the operator. 

The etiology or causation of uterine catarrh resolves 
itself into predisposing and exciting causes. Predisposi- 
tions are defined as that constitution or condition of the 
body which disposes it to the action of disease under the 
application of an exciting cause. Persons who possess a 
thoroughly healthy constitution may be exposed to exciting 
causes without the slightest danger of contracting diseases, 
to which others who are predisposed fall victims. The pre- 
disposing causes of endometritis are a naturally enfeebled 
constitution; the existence of a scrofulous or tuberculous 
habit; impoverishment of the blood from chlorosis; pro- 
longed mental depression; improper and insufficient food; 
prolonged lactation; frequent parturition under unfavorable 
surroundings; any indiscretion after delivery which inter- 
feres with the regeneration of the womb; styles of dress that 
depress the uterus ; want of fresh air and wholesome exercise- 
Professor T. G. Thomas, in his work on Diseases of 
Women, asks the question why most of these influences 
should produce this affection more than others. His answer 
is that " they do not do so." "Sometimes they cause chronic 
pneumonia; at other times granular lids, and again at other 
times chronic endometritis." 

The exciting causes laid down by the same eminent 
authority are "displacement of the womb; excessive or in- 
temperate coition ; the use of intra-uterine pessaries ; puer- 
peral endometritis; exposure or fatigue after confinement; 
efforts at production of abortion and prevention of concep- 
tion; vaginitis either simple or due to gonorrheal infection; 
painful obstructive menstruation; exposure during men- 



214 HOME TREATMENT. 

struation; sudden checking of the menstrual flow; and 
tumors in the uterine cavity or walls." Some of the causes 
here enumerated are much more fruitful of the disease than 
others. A woman whose constitution has been weakened,, 
and whose digestion is deranged, by habits of indolence and 
luxury, whose style of dress so depresses the abdominal 
viscera that her uterus is pressed down into the vagina,, 
is particularly liable to develop a catarrhal inflammation 
from connubial approaches. When these are not without 
pain, then there is some predisposition that should be in- 
quired into and righted. 

Uncleanliness is not spoken of by authorities as among 
the causes of uterine catarrh, yet it is a very frequent one. 
I have succeeded in curing so many catarrhal affections of 
the vagina and uterus by simply advising the use of vaginal 
irrigations with borated warm water, that I am convinced 
that a lack of personal cleanliness is a very prolific cause of 
this affection. The accessible generative organs, both of the 
female and male, should be the object of thorough rinsings 
so as to reduce the possibility of infection to the least degree. 
All mucous membranes have their natural secretions, and 
these are on light provocations abnormally increased. The 
vagina is always the seat of more or less bacterial fermenta- 
tion or decomposition, and if this is retained for any length 
of time, it becomes not only putrid and offensive, but also a 
direct source of infection to the mucous membrane of the 
womb. This is more so in a married woman, who is ex- 
posed to the carelessness of her male consort, who has not 
been apprised of the dangers of septic infection, that may be 
innocently communicated to the wife by negligence of his 
own person. The wife is exposed to all and every impurity 
that the male has on his person, and thus she is in constant 
danger of having her internal organs infected, from the outer 
organs of the male. 

There is no doubt that many women become infected 
from this source, and that obscureand stubborn catarrhs of the 



ENDOMETRITIS. 215 

vagina and womb are strictly traceable to personal unclean- 
liness of the male. From the researches of Dr. Noeggerath 
of New York, it would seem that in a great many cases of 
pelvic diseases in women, the affections can be traced to a 
latent gonorrhoea in the male. This phrase means a gon- 
orrhoea in the male apparently cured, which even two years 
after the supposed cure infects a healthy vagina, causing a 
discharge and a complication of the uterine mucous mem- 
brane. I have seen some cases that fully corroborate the 
views of Noeggerath, so that before we put the blame of 
uterine disease solely on the shoulders of the wife, let us 
find out how much the husband is to blame. 

Specialists in particular, but doctors in general, often 
forget that a woman has other organs besides a womb and 
ovaries; there is a relation of cause and effect between val- 
vular lesions of the heart or diseases of the lungs, that ob- 
struct the return of the venous systemic circulation to the 
right cavity of the heart, and catarrhal diseases of the pel- 
vic organs. 

Biliousness or an affection of the liver, that interferes with 
the portal circulation, or the pressure of tumors or swellings 
on the uterine veins, are also among the causes, while the 
accumulation of feces or habitual constipation is often over- 
looked as too trivial to deserve professional notice, and j^et 
its removal is often the only successful means to cure the 
patient. 

The various eruptive and infectious diseases, like small- 
pox, scarlatina, measles or typhoid fever, may excite in their 
course a uterine catarrh, that will remain behind as a 
chronic complaint, after the acute affection has subsided. 

The acute variety of endometritis is much more preva- 
lent as a disease than is commonly supposed, but, owing to 
an absence of specific or definite signs, pointing directly to 
the mucous membrane, which the woman herself can recog- 
nize, it is generally mistaken for something else. 

The disease begins with signs of an active congestion in 



216 HOME TREATMENT. 

the pelvic organs; such as drawing pains in the small of the 
back and in the groins, and a feeling of fullness and weight 
at the bottom of the pelvic floor. The urine is voided with 
pain and there is a sensation of heat in some parts of the 
urethra. Pressure on the lower abdominal region is painful, 
and the sensitiveness diminishes from the middle towards one 
or the other side. In mild cases these symptoms are not ac- 
companied with fever, headache or a disturbance of the nerv- 
ous system; there may be diarrhoea due to reflex irritation 
of the rectum, and the stools are accompanied with bearing- 
down pain. After three or four days there is usually a dis- 
charge of a viscid liquid, which in eight or ten days be- 
comes creamy, purulent and often tinged with blood. The 
fluids that are discharged from the vagina sometimes be- 
come so acrid and irritating that, w T hen they come in 
contact with the skin of the vulva, abdomen or thighs, it be- 
comes irritated and inflamed, which leads to excoriations 
and an itching, that may spread over the entire body. The 
reaction of this discharge is either acid or alkaline, depend- 
ing upon whether the discharge of the uterus or that of the 
vagina predominates; as the discharge from the uterus is 
always alkaline and that from the vagina always acid, there 
is nothing of a practical diagnostic value in ascertaining the 
chemical reaction of the secretion. The vagina will gen- 
erally be found to be hot and more, or less swollen as in or- 
dinary vaginitis. The womb itself, however, will be en- 
larged and sensitive, while the cervix is gaping or open. 
Through the speculum, it is seen to be red and congested, 
and from the gaping mouth there issues a clear, albumi- 
nous-looking fluid or a muco-pus. 

In the subacute or chronic form the symptoms are by 
no means always so prominent as to indicate the existence 
of the affection, or they are so marked, by some of the nu- 
merous complications, which are in the nature of cause or 
effect, thatf its recognition will become extremely difficult. 
The effect which the disease has on the general organism 






ENDOMETRITIS. 217 

varies greatly in different individuals. Some women of ro- 
bust appearance have an aggravated form of uterine catarrh 
without any immediate ill effects on their nutrition or gen- 
eral health. Other women lose flesh early and become 
weak and worn;- they become pale, and the face assumes a 
yellowish ashen hue with dark rings under the eyes. 
Through reflex irritation from the nerves of the uterus 
other nerve centers become involved, so that a general 
neurasthenia becomes developed with its characteristic con- 
comitants of neuralgia, muscular spasms, uterine colic and 
hysteria. 

With a third class the inflammation spreads from the 
lining membrane to the substance of the womb itself, caus- 
ing an enlargement of the uterus, which induces displace- 
ments and a dragging sensation in walking, pain in coitus 
and painful defecation. The inflammation does not limit 
itself to the womb, but an ichorous discharge creates dis- 
tressing symptoms of vaginitis, inflammation of the bladder, 
and pruritus vulvae. 

When the uterine cavity is the seat of an abnormal vas- 
cular activity, there often exist symptoms of pregnancy that 
may mislead the patient or physician. Nausea and vomit- 
ing are sometimes present, the darkening of the skin around 
the nipples, and an enlargement and sensitiveness of the 
breasts, meteorism, or a swelling of the abdomen, caused by 
the accumulation of air in the intestinal canal from reflex 
nervous irritation, and when this symptom is added to the 
irregularity of menstruation, it is easy to fall into the error 
of diagnosing pregnancy. 

Sterility on the one hand, and habitual abortion on the 
other, should direct attention to the probable existence of 
endometritis. Very often barrenness has led to an investi- 
gation of the condition of the uterus which disclosed the ex- 
istence of the disease. A woman who conceives, and then 
loses her child in the first months of pregnancy, is afflicted, 
in all probability, with a chronic endometritis. In these 



218 HOME TREATMENT. 

cases, where conception takes place, it is to be presumed 
that the sensitiveness and irritability of the inflamed mu- 
cous membrane is not suitable for the permanent fixation of 
the ovum, so that the slightest shock will open the flood 
gates of a congested uterus, and thus the embryo is sepa- 
rated from its attachment, and lost. 

The cervix is sometimes the seat of a special feature of 
uterine catarrh, that is due to the chronic inflammation of 
the cervical mucous membrane, stimulating a growth or 
proliferation of its own tissue or structure. This growth 
causes an enlargement and elongation of the entire cervix, 
and a spreading of the lining membrane of the cervical canal 
to the vaginal surface of the cervix. This encroachment of 
the cervical lining on the vaginal lining is the displace- 
ment of the pavement epithelial cells of the vaginal portion 
by the cylindrical or columnar epithelial cells of the cervical 
canal, and this gives rise to erosions and follicular ulcers. 

These erosions have a glandular arrangement, and are 
often mistaken for cancerous or malignant growths. There 
is no doubt in my mind, that most of the so-called success- 
ful cures of cancer were nothing but cures of erosions. 

The microscopists, whose lively imaginations make them 
see things that do not exist, would make us believe that 
they can take a small section of the suspected growth, and 
establish the existence of cancer by microscopical examina- 
tion; this is utterly impossible, because the cancer cell is no 
different from normal cells, and in erosions we often find the 
follicles so close to each other, and their cells so closely 
packed, one on the other, that no candid mind can say 
whether it is a malignant or an innocent growth. 

The claim that "nests of epithelium cells," as the stereo- 
typed phrase goes, constitute scientific evidence of cancer, is 
utterly absurd. Such eminent authority as Professor Arnold, 
of Heidelberg, makes the assertion that positive diagnosis of 
cancer, from a small section or scraping, is impossible. I am 
myself fully convinced of the truth of this assertion, for while 



ENDOMETRITIS. 219 

I was making microscopical studies in Germany, I had 
abundant evidence of the truth of this statement. It is 
indeed very unfortunate, both for science and suffering 
humanity, that as yet there is no absolute means of diag- 
nosing cancer positively, and for that reason the quacks, 
and those who are not quacks, will continue to fleece their 
victims for supposed cancer. 

I believe that the cause of cancer is either due to a pto- 
maine or organic poison that is generated in the body, or to a 
specific germ or bacillus. If it be due to the latter, and the 
germ theory of disease makes that highly probable, there is 
no doubt that a method of staining will soon be discovered, 
that will make the specific microbe recognizable in the field 
of the microscope, but as yet most cancer diagnoses by mi- 
croscopy are only surmises. 

TREATMENT. 

Continence in sexual intercourse is one of tne prerequi- 
sites to the successful treatment of all uterine diseases. 
This is so often overlooked by those giving advice in such 
matters, that their otherwise appropriate suggestions for 
treatment are frustrated. The women who are suffering, 
appreciate the value of this interdiction without further ar- 
gument, but the average man does not appear to have the 
common sense to readily comprehend that the mechanical 
irritation incident to the sexual act, and the accompanying 
physiological congestion, will surely aggravate an inflam- 
matory process, no matter of what nature. Men, whose an- 
imal instincts dominate their entire being, so that reason, 
if they ever had any, is dethroned, should stop to consider 
their immoderate conduct, which perpetuates the suffering 
of their wives from ailments which men themselves have 
often inflicted, and for which women are innocent martyrs, 

The acute variety of uterine catarrh is to be treated like 
all other acute inflammatory diseases. 



220 HOME TREATMENT. 

The patient should at once take to bed, so that she may 
keep herself warm and quiet. 

If the inflammation is due to cold or exposure during 
menstruation, and the menstrual flow has been suddenly 
checked, then three or four leeches, applied to the inguinal 
regions on both sides, will be of decided advantage. Over the 
lower abdominal regions hot compresses should be applied ; 
these are made by wringing cloths or a large folded towel out 
of hot water, over which a piece of oiled silk, rubber, or oil- 
cloth is laid to retain the heat and moisture. At other 
times, that is, when the inflammation is not due to cold 
and a sudden stoppage of the menses, the application of ice 
bags is preferable to the hot compresses, in the manner else- 
where described. 

The pains which are felt in different parts of the pelvis 
are relieved by using the Femina vaginal capsules; say one 
every six to eight hours, after a hot vaginal injection of 
plain water, or a hot sitz-bath. If there is nausea or vom- 
iting that too is often relieved from the soothing influence 
of the capsule which allays the nervous irritability. 

Should the stomach not be in a condition to take nour- 
ishment from biliousness or other causes, prescription No. 
ii on page 138 should be taken in tablespoonful doses every 
four hours until the stomach is settled and the system regu- 
lated ; if any food is taken it should be between times and 
of a liquid nature. 

If there is straining or diarrhoea, I prefer to employ an 
enema of one pint of warm German chamomile tea, to 
which half a teaspoonful of McMunn's elixir of opium or 
laudanum is added. If the pain and straining are very 
severe, one teaspoonful of either is not too much; by re- 
questing the patient to retain the enema for ten or fifteen 
minutes, the medicine is directly absorbed, and the effect is 
both soothing and healing. This may be repeated several 
times a day, if the pain does not subside after the first in- 
jection. 



ENDOMETRITIS. 221 

The bowels are sometimes found to be in an opposite 
state, namely, con stipated ; this must be relieved at once. An 
enema of warm soapsuds answers the purpose, or a half- 
tablcspoonful of warm water, in which a half-tablespoonful 
of glycerine is dissolved, makes an excellent injection for 
constipation. 

Hot vaginal irrigations should be at once commenced, 
and repeated as often as twice or three times a day. I al- 
ways dissolve a teaspoonful of powdered borax in the hot 
water, of which no less than half a gallon is used at one 
time ; this is antiseptic and healing. After six or eight days, 
once a day will be sufficient. 

Chronic uterine catarrh or uterine leucorrhcea does not 
require the active treatment which was recommended for 
the acute form. It depends quite often on causes, whose re- 
moval is absolutely necessary to the intelligent and successful 
treatment of the affection. 

The causes that have been enumerated must be carefully 
and repeatedly reviewed, so that each individual case can be 
traced to its source. Those causes that are improbable must 
be eliminated from those that are probable, so that by a 
gradual process of exclusion we narrow the number down to 
those that actually exist. This simplifies the treatment to 
actual conditions that can be intelligently met. 

Vaginal irrigations constitute in the chronic form of the 
disease an accepted and most useful therapeutic resource. 
There is nothing that will ever contraindicate a thorough 
cleansing of the vaginal canal, so that the organ may not be 
bathed in its own morbid and irritating secretion. It is a 
wholesome auxiliary to any course of treatment that may be 
adopted. It avoids self-infection and places the pelvic or- 
gans in the best possible condition for the healing powers 
of nature to work out a cure. 

If the uterine catarrh is the result of a venous obstruc- 
tion due to a congested liver and a general derangement of 
the digestive apparatus, then any local treatment will be of 
no avail without first removing the hepatic derangement. 



222 HOME TREATMENT. 

Costiveness or constipation is a very common complaint 
with women and a very painful cause of womb disease, but 
it is so simple and ordinary in its nature that the wise will 
not deign stoop to notice such trifles, but if it required for 
its removal a surgical operation, for which a handsome fee 
is the inspiring motive, then we should hear of it as often 
as we do of lacerations or flexions of the cervix as a cause 
of uterine catarrh, and its removal would then indeed be- 
come absolutely necessary for effecting a permanent cure. 

Why is it that the treatment of uterine disease has de- 
generated into "professional faking" that is alike disgrace- 
ful to the profession and a daylight robbery of the patient. 
A woman, for instance, is suffering from what she supposes 
to be womb disease. She consults a doctor, or what is still 
worse, a time-serving specialist, who examines her and sees 
at once signs of uterine catarrh. 

He at once applies a little tincture of iodine or carbolic 
acid diluted with glycerine or a solution of nitrate of silver 
to the cervical canal. The woman is now informed that 
this application must be repeated two or three times a week, 
for which she must call at the office that number of times 
every week, for an indefinite period. At each visit she is 
subjected to the same routine humbuggery for local medica- 
tion, but does she get any better? In my early professional 
experience I innocently and ignorantly tried these methods 
myself, and I say no ! But, as a matter of fact, this constant 
irritation and poking around and into the womb will in- 
flame any healthy uterus, and much more one that is al- 
ready slightly irritated, so that patients lose their hope and 
become convinced themselves that they are no better, but 
feel worse than when they first commenced treatment. 

This inefficient treatment, like the examination, is con- 
jectural and mechanical and therefore incomplete and 
unscientific. The cause of her entire trouble is never 
approached. The woman suffers for years from constipation, 
which also inclines her to piles, because the pressure of the 



ENDOMETRITIS. 223 

hardened feces on the hemorrhoidal veins obstructs the flow 
of venous blood and the same pressure on the uterine veins 
congests the mucous membrane of that organ and gives 
rise to the symptoms of endometritis. All these conditions 
should be inquired into, and many others, before local treat- 
ment is decided on; simply running to the doctor's office 
and having these medical applications made to the cervix 
or canal of the womb amount to nothing; this, as a general 
rule, does only harm, and is as superfluous as if one were to 
take a nasal douche of salt water or some other catarrh 
remedy, whenever he feels a little cold in the head. 

The proper course to pursue in this and similar cases is 
to prescribe an appropriate diet, and regulate the bowels. 
It is precisely in this way that women who have made the 
rounds of the doctors, happen to take some patent laxative 
or nostrum that relieves their constipation, and accomplishes 
the wonderful cures of which we often hear and that were no 
doubt Godsends to the sufferers that were cured, after all the 
first-class doctors failed. By far the greatest proportion of 
cases of uterine catarrh are of a simple and transient nature 
and are only intensified by probing and local treatment. 

When I first began the practice of medicine, I made the 
same mistake in following the advice of books and those 
who should have known better, for they have had ample 
opportunity to be convinced of the fallacy of these local 
measures in the great majority of cases, but some minds are 
incompetent to learn from experience, for that requires close 
observation, and logical reasoning. 

I soon discovered that the catarrhal inflammations got 
worse, in proportion to the trouble and pains I took to treat 
them locally, so that I became ashamed of my ill success 
and abandoned the local treatment entirely, and this I shortly 
discovered was the means of curing them. Instead, I simply 
directed patients to rinse themselves with quite warm salt 
water, that is, a tablespoonful of ordinary cooking salt dis- 
solved in a gallon of water. Now I prefer Femina antiseptic 



224 HOME TREATMENT. 

lotion to the same quantity of water, which has greater heal- 
ing properties than either pulverized borax or common salt. 
I particularly advised them to keep their feet and lower ex- 
tremities warm, regulating their diet and keeping their 
bowels open. I noticed that the patients began to improve, 
and that the improvement continued until they were fully 
restored to health and vigor. This method of treatment 
would not keep an office overcrowded with deluded patients, 
but it proved far more satisfactory to all concerned than 
meddlesome measures, and illustrated one of the most com- 
mon abuses to which suffering women are liable. 

In taking a laxative patients must feel their way as to the 
proper dose to take in their own individual case; constitu- 
tions differ very much in this respect, so that it is impossi- 
ble to lay down one and the same rule for different persons. 
It is not good practice to give medicines three or four times 
a day in cases of habitual constipation, for it is liable to de- 
range the digestion and interfere with the appetite. The 
proper method is one dose at bedtime and this should be 
increased or diminished until the suitable dose of the remedy 
has been ascertained; when this is accomplished, the dose of 
the remedy should be gradually lessened, a few drops every 
day, till it can be entirely dispensed with. If the ordinary 
dose fails to relieve the bowels, an additional treatment of 
glycerine enema at or about the time that the stool is to 
take place is to be employed. One or two teaspoonfuls of 
glycerine should be diluted with an equal quantity of 
water, and by means of a hard rubber piston syringe 
thrown into the rectum. The stimulating effect of glycerine 
on the nerves and mucous membrane, materially assists in 
relieving the torpor of the rectum, which has become insen- 
sitive to the irritation of its natural contents. 

Patients who are costive must get into regular habits of 
relieving themselves, that is, have a regular hour every day 
when to go to stool, then the medicine will in time cure the 
most obstinate cases of constipation, otherwise it is impos- 



ENDOMETRITIS. 225 

sible to cure it. It takes a constant amount of effort to get 
well, so that those who are too indolent or think it too troub- 
lesome to exert themselves, cannot hope to recover. 

If there is great debility and impoverishment of the 
blood, then I would advise prescription No. 1, which are the 
iron pills, of which three pills should be taken three times a 
day. The moderate use of wine, either claret or Riesling^ 
with the food, instead of tea or coffee, is very beneficial, be- 
tween meals a glass of Porter to relieve the gone-in feeling, 
until the system has recovered sufficient strength to do with- 
out it, that is when ordinary exertions are no longer a 
burden. 

The small percentage of cases that do not yield to the 
above treatment, become legitimate subjects for an honest 
specialist, for there may be extensive lacerations of the cer- 
vix that require surgical treatment, or an elongated cervix 
that should be amputated, or a granulated hypertrophied 
membrane of the uterine cavity that should be scraped out ; 
all these operations are without danger if the operator has 
thoroughly mastered the details of antiseptic surgery and has 
the manual skill to do the work properly. 



15 



CHAPTER XVIII. 

THE NATURAL POSITION OF THE UTERUS AND 
HOW IT IS SUPPORTED. 

The uterus is not a stationary fixture in the female pel- 
vis, but enjoys a mobility within physiological bounds, 
which in itself explains the great diversity of opinions 
which may and do arise respecting the normal or abnormal 
position of the womb in any given case. 

When the surrounding organs and tissues of the womb 
are in a healthy condition, and the abdominal walls are not 
compressed by the weight and pressure of skirts, nor the 
liver or diaphragm forced down towards the pelvis by a tight- 
fitting corset, the organ is movable in every direction, with- 
out the slightest pain or suffering. 

The uterus is not tied down by any ligaments, as one 
might imagine from a description of the several ligaments 
that constitute only in a small degree its support, for it 
changes its position in retching, coughing, breathing, sing- 
ing, walking and all other violent movements. 

The question now naturally arises : What is the normal 
position of the uterus, and what constitutes its natural sup- 
ports? To answer this interrogation is to controvert one of 
the most baneful fallacies in gynecological practice, for the 
amount of torturing and useless doctoring to which women 
are constantly subjected, owing to some fancied displacement 
of the womb, illustrates the force of precedent or of accepted 
opinions, that were fortified by years of erroneous teaching. 

It was supposed until quite recently that when the body 
of the womb was inclined horizontally forwards, this was 
unnatural or a sign of disease, until Prof. B. S. Schultze., 

(226) 



POSITION AND SUPPORT OF Till; UTERUS. 227 

director of the gynecological clinic of Jana, successfully 
controverted this doctrine. In his work "Die Pathologic und 
Titer apie der Lageveraenderungen der Gebsermutter ," which is 
the most classical work extant on displacements of the uterus, 
says: " From the post-mortem findings it was inferred that 
the uterus occupied in the living woman the same position 
as in the cadaver; such an assumption did not take into ac- 
count the actions of the muscles on the position of the uterus 
in the living subject nor the intra-abdominal pressure which 
is entirely absent after death, so that the dead organ natu- 
rally gravitated backward after the remains had lain for 
several days on the back." Another observer, Dr. Hach, 
found in a number of cases that he had examined during 
life, the uteri bent forward or antiflexed; twenty-four hours 
after death he discovered the same uteri in an opposite di- 
rection or retroflexed. 

This and similar subsequent researches have demon- 
strated the fact that when the body of the womb rests on 
the bladder it is not in an abnormal position as formerly 
supposed and called anteversion or anteflexion, but that it is 
natural for it to be so, and when the body is elevated and 
its axis forms an obtuse angle with the horizon, the inclina- 
tion is a post-mortem condition. 

With these precursory remarks I am now able to answer 
the first clause of our query, and w T ould say that the uterus 
is in its normal position when its long axis is nearly parallel 
to the horizon or at right angles with the perpendicular or 
long axis of the body. The normal position of the uterus 
is modified when the bladder is full or distended, for this 
lifts the body of the uterus upwards, thus temporarily mak- 
ing an acute angle w T ith the vertical axis of the body, w r hich 
was formerly considered to be the permanent and natural 
pose of the organ. 

In referring to the bony pelvis, Plate I, it w T ill be ob- 
served that the same is in the nature of a canal, for the pas- 
sage of the child into the world. At other times than dur- 



228 HOME TREATMENT. 

ing the child-bearing process, this canal must be effectually 
closed to perfectly retain its contents. To accomplish this 
purpose it is provided with a bottom or floor, which is to 
give this necessary support, not only to the organs that 
the pelvic cavity contains but also to the abdominal viscera 
that are superimposed upon them. In order to accomplish 
this, its outlet must be as effectually closed as the bottom of 
a box or barrel in which material things are stored for the 
purpose of carrying them from place to place. In the hu- 
man subject this bottom is called the pelvic floor, because 
it serves the purpose of a bottom or floor to the pelvic canal. 

The pelvic floor is not a simple structure but a complicated 
arrangement of organs and tissues. If we begin to examine 
it from below upwards, we first have its outer covering in 
the skin ; then, the superficial and deep fascias, the triangu- 
lar ligament of the bladder and a group of interlacing mus- 
cles. The organs that enter into the composition of the 
pelvic floor and interwoven with the preceding structures,, 
are the bladder, the vaginal walls, the rectum and connec- 
tive tissue. Examine Plate II. 

Through this floor there are several openings, which are- 
guarded by a special set of constrictor muscles that aro 
termed sphincters. These are sufficiently strong in the blad- 
der and rectum but in the vagina they would be entirely 
insufficient to close this canal effectually. 

The vagina, or, for our purpose, it will be clearer if we say 
"vaginal canal" divides the pelvic floor into an anterior and 
posterior segment, and it is by means of this division that 
the whole structure of the pelvic floor is weakened ; this will 
be perceived at a moment's reflection, when we compare it. 
with the pelvic floor of the male, who has no vagina ; and for 
this reason men are never troubled with the prolapses to 
which women are liable. Nature, however, has made an 
attempt to compensate this physical defect in a manner that 
reduces the weakness occasioned by the vaginal canal to its- 
minimum. The vaginal canal does not enter the pelvic 



POSITION AND SUPPORT OF THE UTERI'S. 229 

cavity in a directly upward or perpendicular course, but 
obliquely upwards and backwards, as may be seen by re- 
ferring to Plate II. The result is that the intra-abdominal 
pressure falls on the vaginal walls from above, and thus 
compresses and approximates the anterior and posterior 
walls of the vagina to each other, so that it constitutes a 
self-closing valve, but, notwithstanding all these provisions, 
this slit or opening through the pelvic floor still remains the 
weakest point of the inclosure for the pelvic and abdominal 
viscera. When the causes are sought that underlie the va- 
rious displacements of the uterus, they are generally to be 
found in an impairment of the pelvic floor, through some 
changes or accidents that are peculiar to pregnancy and de- 
livery. 

As we are also to inquire in the succeeding chapter into 
the displacements to which the womb is liable, it would 
greatly assist our understanding if we first got an idea of 
what constitutes the natural supports of the uterus? The 
word ligament is defined as anything that ties or unites one 
thing or part to another ; a bandage ; a bond. This is the 
idea in the popular mind, so that when the terms broad and 
round ligaments of the womb are employed it is supposed 
that they are for the same purpose for which ligaments are 
usually intended. This is, unfortunately for a clear under- 
standing of the subject, a great mistake, because these liga- 
ments are an exception to the generally accepted meaning of 
the term, for they neither tie nor support the uterus in its 
natural position. One may readily imagine that this erron- 
eous conception would lead to a mistaken course in the 
treatment of most cases of displacements, because too much 
importance is bestowed upon structures that have no physio- 
logical bearing on the disease. 

Drs. Hart and Barbour, of Edinburgh, in their " Manual 
of Gynecology," which is the most scientific and practical 
work that has lately appeared in the English language, have 
this to say in speaking of the support of the uterus: "The 



230 HOME TREATMENT.. 

question of the support of the uterus is still disputed. The 
broad and round ligaments have nothing to do with its 
support, they are only useful as giving fixed points for the 
contracting uterine muscles during parturition. The chief 
support is the compact unbroken pelvic floor, on which the 
uterus rests just as one sits on a chair. It is the whole pel- 
vic floor that supports the uterus and viscera, not the peri- 
neum alone." The perineum (see anatomical Plate II) is 
only a small though strong part of the pelvic floor. If the 
reader will now patiently review the organs that, together 
with the other tissues, constitute this floor, and this can be 
most profitably done by studying Plate II, there can be no 
confusion of ideas whatever. In the following pages I have 
occasion to refer to what is understood by the term pelvic 
floor. 



CHAPTER XIX. 

PROLAPSUS OR FALLING OF THE WOMB. 

If one desires to familiarize himself with a thorough 
understanding of this subject, it is absolutely necessary to 
bear in mind what was said of the natural support of the 
uterus, for unless one has a full knowledge of the foundation 
of a structure, how can he comprehend its defects and 
remedy them when the structure falls? The workman who 
potters on a building that has shifted from its foundation 
without first devising means for a new and solid basis for 
it to rest upon, would be considered a fool. The term " fall- 
ing of the womb" has no longer the significance that it 
once had, for it is only a symptom that something is wrong, 
and in the present state of our knowledge it is misleading 
and a misnomer, inasmuch as it conveys the impression 
that it is due to an affection of the uterus, when as a matter 
of fact it is not due to any disease of the womb at all. If 
the prolapsed uterus has become involved in a morbid 
process, it is the result of the abnormal conditions that have 
brought the prolapsus about, and in which the uterus was 
in no way concerned. 

Professor Schroeder, of Berlin, takes a similar view of 
these cases, and he groups into one chapter three distinct 
varieties, yet, because one is depending on the other, he 
considers them all as one disease. These affections are: 
prolapse or falling of the womb ; prolapse or falling of the 
vagina, and an inflammatory elongation or hypertrophy of 
the cervix or neck of the womb. He says " that the dis- 
placement of the womb is very seldom a primary affection, 
but that it is oftener the consequence of a prolapse or falling 
of the vagina, and a giving way of other structures, or of the 

(231) 



232 HOME TREATMENT. 

pelvic floor, and, as such, ' falling of the womb ' cannot be 
properly separated into *an individual affection of the 
womb." 

Falling of the vagina is principally due to a widening 
of the vaginal canal, a relaxation of its walls, and injuries 
or lacerations of the pelvic floor. Lacerations of the peri- 
neum generally occur during confinement, in which the 
vagina tears through the vaginal orifice backwards towards, 
or into, the rectum. This so weakens the pelvic floor that 
it becomes inadequate to support the pelvic organs and 
tissues, and this predisposes to all the varieties of prolapsus 
that have been enumerated above. It is during the period 
of gestation that the vagina grows considerably longer and 
wider. In the latter months of pregnancy the womb as- 
cends and its body inclines greatly forwards, which naturally 
tilts the cervix high up in the pelvis, and also draws that 
portion of the vagina to which the cervix is attached with 
it, but notwithstanding this upward dragging of the vagina, 
the lower portion of the vaginal canal has so augmented 
its proportions that it often protrudes between the lips of 
the vulva during the last period of gestation. The normal 
relation of the vagina to the neighboring organs is more or 
less disturbed, that is, its attachment to the bladder and 
rectum is stretched and loosened, so that under the most 
favorable circumstances the mucous membrane of the lower 
portion of the vagina falls out of the vulva or prolapses, of 
course in the majority of cases only in such a degree that it 
neither inconveniences nor is it noticeable by the pregnant 
woman. 

Immediately after confinement, in a healthy state of 
affairs, nature should rectify these abnormal proportions, 
that were only designed by her to serve a temporary pur- 
pose, namely, to accommodate the child and provide for its 
safe passage into the world. Medical writers have invented 
a special term to designate this process of regeneration, 
namely, involution. This means to infold or grow less so 



PROLAPSUS OR FALLING OF THE WOMB. 233 

as to assume the former natural proportions of organs. 
Unfortunately, nature is often contravened in her whole- 
some regenerative purpose, by adventitious circumstances 
that completely frustrate her intentions, and the reparative 
process being thus balked, the organs and tissues remain in 
their abnormal proportions, which constitutes now a disease, 
and this uncompleted effort to repair is termed sub-involution. 

It takes at least from six weeks to three months after 
delivery for the reparative process or involution of the or- 
gans and tissues to be completed. And women cannot ex- 
ercise too much care after confinement to avoid any possible 
check to the regenerative process. If the involution has been 
arrested, the vagina retains its large, flabby proportions, so 
that its relaxed walls naturally protrude or prolapse, and 
that entails all the other consequences. 

Intra-abdominal pressure should be explained in con- 
nection with this subject, for it constantly encourages pro- 
lapsus of the organs under consideration. By that is meant 
the pressure which the contents of the abdominal cavity 
exert on its walls, and this is greatest at its most dependent 
part, which is the pelvic floor. This pressure is continuous 
on the organs of the pelvic floor while the woman is stand- 
ing, and greatest at the point of least resistance, which is the 
relaxed and enlarged vagina, so that it bulges out at the 
vaginal orifice. When the patient resumes a recumbent 
position, this point is greatly relieved from pressure, and 
the vagina may regain its normal relations, but whenever 
the woman is in the upright position, the intra-abdominal 
pressure will again force the weakened pelvic floor and 
vaginal walls downwards. After a time the prolapse no 
longer subsides after the pressure is reduced, for the tissue s 
have lost their recuperative power, and the prolapse be- 
comes permanent. When the intra-abdominal pressure is 
supplemented by the action of the diaphragm and the con- 
traction of the abdominal muscles, as occurs in a long par- 
oxysm of coughing, repeated vomiting, and inordinate and 



234 ' iHOME TREATMENT. 

prolonged bearing down at stool, a prolapse may take place 
quite suddenly, precisely as in a rupture or hernia, and for 
these reasons some authorities (Drs. Hart and Barbour, of 
Edinburgh) have described prolapsus of the womb as a sacro- 
pubic hernia. 

A permanent distension of the bladder or an accumula- 
tion of feces in the rectum facilitates the development of a 
prolapse of the vagina, because the former pushes the an- 
terior wall of the vagina downwards, while the latter de- 
presses the vaginal wall. 

A large or subinvoluted uterus is by some considered as 
a fruitful cause of prolapse ; this Professor Schroeder denies, 
and I am convinced from experience that he is right. A 
uterus that is simply enlarged is not inclined to prolapse, 
because the enlarged pregnant uterus never prolapses if the 
pelvic floor is in a normal condition. But a chronic en- 
dometritis or uterine catarrh may in time involve the vagina 
in a vaginal catarrh and this may induce a prolapse. A 
chronic vaginal catarrh or leucorrhcea can so relax the vag- 
inal walls that its lower folds protrude from the vaginal 
orifice. 

Women who are beyond the change of life and in whom 
the lost elasticity of the tissues and a general absorption of 
fatty and connective tissue has destroyed the natural sup- 
port which retains the vaginal walls, may be annoyed with 
partial prolapses of the vagina. 

The most aggravated types of prolapses are found among 
the working classes, who cannot avail themselves of the 
comforts and hygiene of the lying-in chamber that are so 
essential for a complete and permanent recovery. 

Elongation or hypertrophy of the cervix of the uterus is 
the third variety of prolapses that Professor Schroeder in- 
cludes in the group. This form is consequent upon a fall- 
ing or prolapse of the vagina, and it occurs in the following 
maimer. The body of the uterus being retained by its 
natural supports or by adhesion of a former inflammatory 



PROLAPSUS OR FALLING OF THE WOMB. 235 

process in the pelvic cavity, remains stationary where it 
naturally belongs, while the upper end of the vaginal canal 
being attached to and surrounding the cervix or neck of the 
womb, gradually draws or stretches the cervix out, so that 
it grows one or two inches longer than it is natural for it to 
be. The cervix of the womb projects under these circum- 
stances down into the vagina, and in some cases it may be 
seen between the lips of the vulva. This condition is mis- 
taken for falling of the womb, when in reality it is a falling 
of the vagina with an incidental lengthening of the cervix 
of the womb. To recognize and make these distinctions is 
of the greatest practical importance, for thus alone can the 
measures adopted for the relief of these distressing com- 
plaints be successful. 

The symptoms of prolapsus grow principally out of the 
changed relations of the uterus to the surrounding organs 
and tissues. The mechanical interference and pressure of 
the womb on neighboring parts, and the changes that are 
induced in the organ itself by the altered circulation in its 
tissues, cause the inflammatory enlargement or hypertrophy 
that is characteristic of one variety of the affection. 

In some persons the development of the disease is so 
gradual that it has progressed for years without any serious 
inconvenience and the symptoms that did exist were gener- 
ally attributed to other causes. In the course of time there 
is such a combination of morbid processes, like painful men- 
struation, inflammatory enlargement of the womb and ero- 
sions of the cervix with profuse leucorrhoea, as to render 
the parts painful and sensitive to pressure and friction. 
These symptoms excite in the end suspicion, so that the 
sufferer may seek advice that will reveal to her the real con- 
dition of her case. 

Other signs of these affections are a dragging down or a 
feeling as though a weight pulled the pelvic organs down- 
wards ; there is also traction on the bladder, making this vis- 
cus exceedingly irritable, so that there is a frequent desire 



236 HOME TREATMENT. 

to micturate; the rectum suffers also from similar traction. 
There is another sign that is very often present, and partic- 
ularly in the early stages, and this is a feeling as if the va- 
gina was open ; this is due to the relaxation of the vaginal 
walls. Walking for any distance becomes burdensome and 
causes great fatigue ; pain in the back and loins is hardly 
ever absent. There is an inability to lift weights, because 
the pelvic floor cannot endure the extra strain that is super- 
imposed on the intra-abdominal pressure; ascending or de- 
scending stairs aggravates the symptoms much more than 
walking on the level floor. 

TREATMENT. 

This must be directed to the accomplishment of two 
ends, without which no relief, much less a cure, is possible? 
and these are, first, to return the displaced organ to its nor- 
mal position, and, secondly, to retain it there. The course first 
indicated is, as a rule, not difficult to follow out ; in fact, if 
the patient is placed in a favorable position, the uterus re- 
places itself through the natural forces of traction and grav- 
itation, unless it has become so enlarged that it is a physical 
impossibility. 

The "knee-chest" or u knee-elbow posture" is the term that 
has been given to this position, and it is assumed in the fol- 
lowing manner. 

The woman gets down on her knees, the thighs being 
kept in an upright or vertical line; the object of this is to 
keep the pelvis as high as possible, while the chest is bent or 
inclined forwards until the head rests on the floor; the shoul 
ders must be as low to the floor as it is possible for the pa 
tient to endure. 

This position at once reduces the intra-abdominal pres 
sure on the pelvic floor to the least degree, and besides this 
the abdominal viscera gravitating towards the diaphragm 
the prolapsed uterus and surrounding tissues are drawn up- 
wards and forwards with it. If the prolapse was complete 
or nearly so, so that the organ almost protruded through 



PROLAPSUS OR FALLING OF THE WOMB. 237 

the vulva, then the patient should retain this posture for ten 
or fifteen minutes before an attempt is made to replace the 
organ; for the intense congestion should be first allowed to 
subside. 

No sudden or .violent force should be employed, but a 
gentle, steady pressure. In cases where the organ has simply 
descended into the vagina, the knee-chest posture alone will 
replace the uterus. Those displacements that are due to a 
chronic catarrh of the vagina are particularly suitable for 
home treatment, because the patient can surely cure her 
vaginal catarrh, and combining with this the knee-chest pos- 
ture, which should be practiced night and morning, for at 
least ten minutes, and until the catarrhal inflammation has 
entirely subsided, she has at her command the most useful 
and beneficial resource to accomplish a cure. 

If the reader will refer to page 179 and note carefully what 
was said in this connection, she will learn that the phrase fall- 
ing of the womb is sometimes nothing more or less than a 
relaxation of the vaginal walls that is due to a chronic ca- 
tarrh of the vagina. It is quite natural that it should be so, 
for if the structures that make up the pelvic floor lose their 
tonicity and strength, the womb must naturally descend. If 
we now succeed in temporarily replacing the organ by assum- 
ing the knee-chest position, and in the meantime cure the 
catarrh and inflammation the patient must get well. The 
reader is again referred to the chapter on vaginal catarrh. 

The fatigue or lassitude which makes every physical 
effort of some patients a great hardship, can be greatly re- 
lieved, if not cured, by this formula. 

no. x. 

Take: Tincture of nux vomica 2 drams 

Fluid extract of ergot 4 drams 

Fluid extract of golden seal 1 ounce 

Compound elixir of calisaya sufficient to 

make 8 ounces 



238 HOME TREATMENT. 

Directions: A tablespoonful three times a day, between 
meals. 

When the prolapse is due to some of the structural de- 
fects that were enumerated in the causation of displace- 
ments, and that were traced to the accidents of childbirth, 
then no permanent relief can be hoped for, until these de- 
fects are remedied. 

Pessaries or rings that are introduced into the vagina 
for the purpose of stretching or spreading out the relaxed 
folds of the vagina, that they cannot prolapse or fall down, 
and thus indirectly support the uterus, were suggested by 
the ancient fathers of medicine. In view of the fact that 
they were wholly ignorant of the causes that were responsi- 
ble for prolapses, the remedy was quite practical and in- 
genious, but to-day, when we are acquainted with the causes 
that operate in bringing the prolapse about, they are, to my 
mind, a very unsatisfactory 'makeshift, and afford only a 
temporary amelioration. 

A woman who is compelled to wear a ring or pessary is 
certainly not well, and if she has any hard work to do or 
must be on her feet a great deal, the pessary will sooner or 
later so irritate the vagina that it must be removed. Be- 
sides this, I always contended that, in the long run, this 
extra strain on the vaginal walls would only relax them 
more, and, instead of ever being able to dispense with the 
use of a pessary, she must increase the size after a while. 

There are a great many devices in the form of pessaries; 
some of them are absurdly ridiculous, and more in the 
nature of instruments of torture than of remedial expedients. 
Since I learned to know better, I no longer recommend 
them, and those who desire a radical cure for a prolapse of 
any kind, will surely be disappointed if they pin their faith 
to them. 

I am convinced that they are a great source of evil, and 
a sure index of ignorance on the part of those who habitu- 
ally recommend them. The German school of gynecolo- 



PROLAPSUS OR PALLING OF THE WOMB. 239 

gists have of late years greatly perfected the plastic operations 
of the vagina, in fact, it is almost a sub-specialty in itself, to 
which they have given the term prolapse operations. A 
specialist, who is competent in the details of these prolapse 
operations, can hold out the very best possible chance for a 
radical and permanent cure, and while the operation re- 
quires a certain degree of skill and special training, which 
should be obtained by practicing these operations on the 
cadaver, in order to save time, and not bungle the operation 
on the living subject, as too often, unfortunately, happens. 
In skillful hands, the operation is entirely without danger, 
and under proper antiseptic precautions, the results are very 
satisfactory. 

The question is simply this: If the knee-chest treatment, 
and the remedies that have been suggested, do not give per- 
manent relief, then there must be some such defect in the 
pelvic floor as I have heretofore described. 

If the vagina is too wide, it should and can be narrowed 
to its normal dimensions, by removing the excessive tissue ; 
if the vagina is torn into the perineum, this too must be 
united. Should the cervix of the uterus be abnormally 
elongated, so that it makes it physically impossible to return 
it to its natural position, it should be shortened or ampu- 
tated, and if all these three complications coexist, then an 
operation combining and remedying all these defects, should 
be performed at one sitting. This method alone will restore 
the patient to health and usefulness. 



CHAPTER XX. 

VERSIONS AND FLEXIONS OF THE UTERUS. 

Version, in the nomenclature of diseases of the womb> 
means that the entire organ without any deflection in its 
normal axis turns, inclines or leans either forwards, back- 
wards or sidewards. 

The prefix ante is used in the sense of forwards and in 
composition with version we have the word anteversion, which 
in conjunction with the term uterus, signifies that the organ 
is inclined forwards. The prefix retro, signifies backwards, 
and in composition with the word version and in connection 
with the word uterus, it implies that the womb is turned 
backwards. 

The word flexion differs from version, inasmuch as it sig- 
nifies a bending or bowing, which breaks the normal axis 
of the womb. The neck or cervix of the uterus may retain 
its normal position, while its body is abnormally deflected or 
bent in any direction. The prefixes ante and retro are also 
used in composition with the word flexion as they are with 
version. These distinctions should be remembered. 

ANTE VERSION OF THE UTERUS. 

In anteversion the uterus has so far changed its normal 
shape that the cervix of the organ is stretched out or ex- 
tended in a line with the axis of the body. This occurs 
when the uterus is unusually swollen from inflammatory 
enlargement. The normal location of the body does not 
materially change in these cases. It is a little more de- 
pressed on the fundus of the bladder and the cervix is 
correspondingly elevated, so that the latter stands consider- 
ably higher than in health. If the bladder is empty, and 
(240) 






VERSIONS AND FLEXIONS OP THE UTERUS. 241 

the patient bears down or does anything that increases the 
intra-abdominal pressure, the body of the womb is forced 
down, upon the anterior vaginal wall, which prolapses into 
the vagina, while the cervix is raised, so as to point upwards 
and backwards. When the bladder is full, the body of the 
uterus is naturally raised, and the cervix correspondingly 
depressed. And this is attributable to a rigidity or stiffness 
about the organ, that is characteristic of a chronic inflam- 
matory enlargement of the uterus. Sometimes the organ is 
permanently fixed by inflammatory adhesions, that lessen 
or prohibit these movements. 

The symptoms of anteversion are what may be expected 
from an enlarged congested organ. This enlargement is 
due either to a subinvolution of the uterus or to an inflam- 
mation of the intermuscular substance, a chronic metritis. 
One of the most annoying symptoms of the anteverted 
uterus is the feeling of looseness in the pelvic cavity. This 
is partly due to the relaxed state of the surrounding tissue, 
and partly to the abnormal size of the womb. The patient 
feels the organ roll from side to side, as she changes her po- 
sition. This causes unnatural sensations and mental suffer- 
ing that disturbs the nervous system and induces hysterical 
complications. And the patient complains about something 
moving in her abdomen. 

The inflammatory adhesions that sometimes tie down 
the organ in an anteverted position, compromise the nor- 
mal expansion of the bladder; this induces an irritation, 
which causes a frequent desire to urinate. 

The treatment must be directed to the removal of the 
cause. This disease is really only a symptom or condition 
of chronic corporeal metritis or subinvolution, and as such, 
it is only amenable to the measures that will cure this dis- 
ease. The employment of rings and pessaries to remedy 
this evil is contrary to good sense and of no permanent 
value. 

The intelligent employment of electricity, so as to stimu- 
16 



242 HOME TREATMENT. 

late the absorption of the hypertrophic enlargement of the 
uterus and cause the absorption of the inflammatory adhe- 
sions, will often give permanent and positive results. 

ANTEFLEXION OF THE UTERUS. 

This was considered at one time the most frequent of all 
uterine displacements, not because it existed formerly oftener 
than at present, but because the natural or normal position 
of the womb was confounded with that which was supposed 
to be abnormal. 

The discovery that in the living subject the body of 
the uterus naturally inclines forward, so as to rest on the 
bladder, and that the body makes quite an angle with its 
cervix, altered the conception of things very materially* 
To-day an actual aggravated anteflexion, that occasions no 
impediment to the menstrual discharge, is not a proper 
ground for treatment, although this is as yet by no means 
familiar to physicians in general, for many of them have 
not learned to make the distinction. 

The reader should carefully study Plate II, which dia- 
gramatically illustrates how the body bows over the bladder 
so as to show its natural anteflexion. If the angle between 
the body and neck of the womb becomes too sharp or acute, 
so that the canal of the uterus becomes compressed at the 
point of flexion, in a degree that obstructs the escape of the 
natural secretions of the uterine cavity, then the anteflexion 
becomes a source of disease. This degree of flexion is hap- 
pily very rare, and we find it in about equal proportions due 
to a congenital defect, that springs into prominence when the 
girl arrives at puberty, for then the obstruction to the men- 
strual flow is first realized. 

The other class acquire the affection in adult life, after a 
once healthy or natural menstruation has been established. 
Of this class there are two species, which must be separately 
analyzed, so as to avoid a confusion of ideas, that often 
makes this subject, which is the most simple, one of the most 
intricate, in the text books in gynecological practice. 



VERSIONS AND FLEXIONS OF THE [JTEBUS. 243 

One variety of the acquired affection can be described, 

in common with the congenital form, to which I first re- 
ferred : because the anteflexions in both cases are due to 
precisely the same pathological conditions, namely, a loss 
of muscular tone in the uterine walls, so that the organ be- 
comes flabby and weak, like a green wilted stalk, allowing 
the body of the uterus to topple forwards. 

The relaxation of the uterine walls is usually more pro- 
nounced at that portion which is distinguished as the isth- 
mus of the uterus, and corresponds to that part of the organ 
where the cervix goes over into the body, forming a sort of 
natural hinge joint between body and neck. 

If the bladder is empty, the body of the womb will 
naturally drop, not necessarily forwards, for it may fall 
backwards, but in the majority of cases it drops forwards, 
because the womb is already inclined forwards in its natural 
position, so all that is necessary to induce an excessive 
anteflexion, is for the body of the uterus to sink lower than 
it is natural for it to be. A kink or sharp bend will cause 
in any canal an occlusion. Take a small rubber tube, for 
instance, and bend it sharply at right angles; the result will 
be at the corner of the deflection, that the tube will be flat- 
tened, and its walls will come together. In the case of the 
uterine canal, where there is an abnormal flexion, there is 
precisely the same condition, and as a result an obstruction 
not only to the menstrual fluid, but to the mucous secretions, 
which are pent up in the uterine cavity. The retained fluids 
decompose and irritate the mucous lining ; and this entails 
a complication of inflammatory diseases, which can never 
be cured, unless the flexion is remedied. 

The other variety of the acquired flexion is due to a 
pelvic cellulitis. This is an inflammatory process, entirely 
outside of the uterus. 

The womb is surrounded by a great deal of loose cellular 
tissue, that fills out the interspaces between the different 
ligaments and pelvic organs. This tissue often becomes the 



244 HOME TREATMENT. 

seat of an inflammation. The exudation from the inflamma- 
tion may be of such a nature that it forms strands of fibrous 
tissue, running from the isthmus of the uterus backwards to 
the sacrum. These strands contract or shrink in the- course 
of time, and this draws the isthmus of the uterus backwards, 
and fixes or attaches it to the posterior pelvic wall. By this 
contraction of the fibrous tissue the cervix is constricted and 
the body falls unnaturally forwards. 

The prominent symptoms of anteflexion are painful men- 
struation and sterility. Dysmenorrhcea or painful menstrua- 
tion is the first sign of the existence of anteflexion at the 
age of puberty. It happens that young girls are thus tor- 
tured for days with violent uterine colic, that is occasioned 
by spasmodic efforts of the uterus to force through the con- 
stricted canal the pent-up secretion. This lasts until the 
menstrual fluid has sufficiently dilated the cervical constric- 
tion to allow its escape. These painful paroxysms of uter- 
ine colic repeat themselves at each recurring menstrual 
period, and through these repetitions of pain and suffering, 
the general health becomes greatly deranged. The nervous 
system becomes the seat of functional disturbances, and hys- 
terical disorders are not uncommon. 

The organ becomes involved in chronic inflammatory 
processes that make the uterus exceedingly sensitive, so 
that the colicky pains become aggravated and prolonged 
far beyond the cessation of the menses. Some of these pa- 
tients suffer for several weeks, from the time the courses 
ought to begin, so that they are actually sick half the time. 

Sterility is not an absolute certainty in all these cases, 
but it is traced so often to an aggravated flexion, that it may 
be accepted as one of its most prominent signs. Conception 
has taken place in extreme flexions, because the spermatozoa 
can gain admittance into the uterine cavity for several days 
after the uterine colic and menstrual fluid have forced the 
canal open. And if the uterus has not become involved in 
inflammatory processes, then conception is the means hy 
which nature effects a cure through her own resources. 



VERSIONS AND FLEXIONS OF THE UTERUS. 245 

Daring the menstrual period, the anteflected uterus In- 
comes greatly congested and swollen, and, having already 
grown considerably larger from the chronic inflammatory 
conditions which the anteflexion has induced, it impinges on 
the bladder, so as to interfere with its free expansion. Thk 
occasions a frequent desire to void urine, and this becomes a 
very distressing symptom in a certain proportion of cases. 

Treatment for this affection is not within the sphere of 
the original purpose of this work, for the efforts at home 
treatment must be aided by mechanical methods of the 
physician. From what we are taught of 'the physical cause 
of this affection, the fact seems self-evident that the acute or 
sharp flexion must be modified to give permanent relief. 
The employment of rings, pessaries, sponges or medical ap- 
plications are nonsensical, and the method of introducing a 
stem in the uterine cavity, for the patient to wear for an in- 
definite length of time, is not without great danger. Even 
though a woman cannot give herself all the proper treat- 
ment, it must be a great satisfaction to her to be informed of 
the proper methods that should be adopted. 

The vagina should be thoroughly rinsed before each 
and every treatment of the uterus, so as to guard against 
the possibility of infecting the cavity of the uterus. 

If the manipulations that are required for the purpose 
of carrying out some of the mechanical or surgical treat- 
ments of uterine diseases, were always preceded with 
thorough cleanliness, which implies asepsis, or without 
putrescence, then all these operations would be shorn of 
their greatest danger, namely, that of exciting inflammation 
and suppuration. 

If a probe of the usual curve can be readily introduced 
into the supposed anteflected uterine cavity, then there can- 
not be sufficient flexion to constitute an obstruction, hence 
the flexion is not the cause of the disease. In genuine an- 
teflexion, the cervix and body of the uterus are doubled 
np on each other, often like the letter V, the cervix repre- 



246 HOME TREATMENT. 

sen ting one line of the V, and the body the other; bi- 
mammal palpation in the hands of an expert clearly estab- 
lishes this conformation. 

When the diagnosis is established, the treatment should 
be as follows : The patient is inclined on a table, either on 
her back or side, a Sims' speculum is introduced into the 
vagina and the cervix exposed. The posterior lip of the 
cervix is now seized by means of a tenaculum forceps, and 
gently drawn downwards and backwards^ which greatly re- 
duces or obliterates the angle or flexion between the cervix 
and the body of the womb, this greatly facilitates the in- 
troduction of a uterine electrode. After two or three treat- 
ments, the forceps are no longer required, because the elec- 
trode can then be readily introduced into the uterine cavity 
without them. The other electrode is spread on the ab- 
domen. (See this illustrated on Plate V.) A current of 
electricity is now passed through the uterine tissues for ten 
minutes; this is gauged all the way from sixty to one hun- 
dred milliamperes. The operation is repeated only once a 
week, and the cure is effected in six weeks to three months. 
Great care must be exercised during the treatment, to avoid 
exposure and undue exercise. 

Those forms that are due to inflammatory deposits and 
strands outside of the organ, should be preceded with an 
electrical treatment twice a week, somewhat modified from 
the preceding course. This is done by employing a vaginal 
electrode, properly protected and gently pressed against the 
adhesions. The other electrode is applied to the small of the 
back. A current some fifty milliamperes stronger is passed 
directly through the adhesions; when these are absorbed, 
the intra-uterine electrode is employed, as in cases that are 
not complicated with them. 

RETROVERSION OP THE UTERUS. 

This consists in a posterior inclination of the uterus, so 
that the body of the womb approaches the posterior walls of 
the pelvis, while the cervix of the womb is raised against the 
base of the bladder. 



PLATE IV. 




Retroflexion of the Uterus, or the Womb, bent backward. 



This plate elucidates the womb bent or turned backward and pressing- on the 
rectum. This condition is generally traceable to the vicious custom of lj'ing on the 
back after confinement or during- childbed. The natural position of the organ, in- 
clined forward and resting on the bladder, is also shown. 



VERSIONS AND FLEXIONS OF THE UTERUS. 247 

As a permanent pathological lesion, this form of displace- 
ment is very rare, but as a forerunner of retroflexion it is of 
frequent occurrence. The length of time that elapses for a 
version to take on a flexion depends on the degree of indu- 
ration or stiffness of the uterine walls. 

The chronic inflammatory enlargement of the uterus 
predisposes the organ to posterior displacement, and the dis- 
placement favors the development of flexion. This takes 
place in the following order : After the uterus is displaced 
backwards, and its cervix has become fixed by inflamma- 
tory adhesions, the body of the womb gradually glides down 
on the posterior pelvic wall, from gravitation and intra- 
abdominal pressure. And in this very simple manner a 
retroversion is converted into a retroflexion. The causes, 
symptons, and complications that characterize this variety 
of displacement, with its subsequent modification into flex- 
ion, are the same as those of retroflexion, to which the 
reader is referred. 

RETROFLEXION OF THE UTERUS. 

This form of uterine displacement exists when the body 
of the womb is bent towards the posterior wall of the pelvis, 
which is in an opposite direction to that where it naturally 
belongs. I have already pointed out, in speaking of the 
normal position of the uterus, that the body is directed for- 
wards and rests on the bladder, while its cervix points 
downwards into the pelvic cavity. I now refer you to Plate 
IV, in which I plainly show the uterus in a directly oppo- 
site position to that in health, namely, turned back, resting 
on and depressing the rectum. 

In retroflexion the cervix of the uterus continues to point 
downwards, into the pelvic cavity, in almost the same di- 
rection as in the natural position, while the body is directed 
backwards, or backwards and downwards. We seldom, if 
ever, find this condition as a congenital affection, but as an 
acquired displacement it is undoubtedly more frequently 



'^48 HOME TREATMENT. 

met with in gynecological practice than all other displace- 
ments combined. The round ligaments of the uterus were 
at one time, and are even yet by some, supposed to be the 
means that retain the womb in its normal anteflected posi- 
tion. Upon this theory a new surgical operation sprung 
into prominence for the relief of this class of cases. It was 
reasoned, that if the round ligaments actually tied the uterus 
down, and retained it in its natural anteflected position, that 
to shorten these ligaments by opening the inguinal canal in 
the groin, and drawing them out, would remedy a displace- 
ment of the womb, whether a prolapsus or a retroflexion. 
This operation was performed, it was claimed successfully, 
and if the view that the round ligaments retain and support 
the uterus were a correct one, it must be admitted that the 
operation would have been ideal. I convinced myself, how- 
ever, of the utter fallacy of this position, in dissections on the 
cadaver, where in several instances the round ligaments 
could not be reached without opening the abdominal cavity, 
and even then it was impossible to trace them. These 
views were expressed in an article in the American Journal 
of Obstetrics and Diseases of Women and Children, and as the 
operation fell shortly afterwards into merited disrepute, I 
partly claim the credit of. having been instrumental in 
bringing that about. I said : 

"That this ligament has nothing to do in fixing the 
uterus in its normal anteverted position, is proven from 
many facts which occur in daily practice. The insertion or 
origin, whichever one chooses to call it, of these cords at the 
groin, is somewhat irregular and sometimes so rudimentary 
that it cannot be found upon a most careful and tedious 
dissection. It may be found divided into a number of proc- 
esses, one being connected with Poupart's ligament in the 
inguinal canal, the other being lost in the labia majora, and 
another may be traced to the sheath of the rectus muscle. 

" If these cords were so important as the advocates of the 
Alexander-Adams operation try to make us believe, in bind- 
ing the uterus forward, and, as we are recently informed, 
have a strength equal to support four and one-half pounds 



VERSIONS A XI) FLEXIONS OF THE [JTERUS. 249 

weight, a great deal of uneasiness, if not actual pain, would 
be felt and located along the inguinal canal, following this 
structure to its points of insertion, in sudden dislocations of 
the uterus backwards. This is, however, not the case; when 
sudden painful symptoms arise, they are invariably referred 
to the sacral region. In sudden retroversions or flexions, 
as in the pregnant uterus, occurring accidentally or those 
retroverted or flexed uteri which are so often met with in a 
state of subinvolution after confinements, there are no symp- 
toms pointing to a tension of these cords at all, but all 
symptoms point to uterine pressure on the posterior pelvic 
wall, which can be precisely located. And these pains dis- 
appear as soon as the offending member is put right." 

There is no doubt that the uterus retains its abnormal 
retroflected position by the same forces that keep it in a 
normal or anteflected state; these are (1) intra-abdominal 
pressure, and (2) the force of gravitation of its own weight. 

In some women there are certain predispositions to the 
occurrence of a retroflexion. If the walls of the uterus are 
weak and relaxed, especially that portion where the cervix 
unites with the body of the womb, then the body may fall 
in any direction, and, as the bladder is liable to be dis- 
tended, and thus raise the body of the uterus upwards, folds 
of intestine are likely to intervene, so that the organ is in- 
clined backwards, and the abdominal pressure, now falling 
on the anterior surface of the body, presses the womb back- 
wards and downwards into a flexion. 

A fall backwards or a violent push or jump may cause 
retroflexion any time during life. Retroflexions of this na- 
ture are not as a rule injurious, and if the circulation is not 
compromised, nor the uterine canal obstructed, women may 
go through life without feeling any the worse because their 
womb occupies an abnormal position. It is only when the 
organ is congested and swollen, so that its own tissue is pain- 
fully sensitive, and the surrounding tissues are compressed 
by the foreign body, that it requires measures for relief. 

In those women who have borne children, and those 
who have gone through a miscarriage, retroflexion is fre- 



250 HOME TREATMENT. 

quently met. A little reflection will make this clear, for 
when we remember how the pregnant nterus at any time 
from conception to final delivery becomes congested and 
the seat of a corresponding growth of its own tissue to ac- 
commodate the growing fetus, we at once perceive that 
either after an abortion or on delivery at full term, the en- 
larged and congested uterus is in the best possible condition, 
to lose its normal place and sink backwards. The per- 
nicious custom in vogue in most countries, of keeping a 
woman on the flat of her back after delivery, has never been 
as vehemently opposed by the intelligent members of the 
profession, as the gravity of the subject demands. Some 
women have an idea that the longer and quieter they re- 
main on their backs, the surer they are to make an excellent 
recovery from the lying-in chamber. American and En- 
glish practitioners are inclined to recommend this as the 
most proper way to lie, but there is no doubt that this not 
only favors the occurrence of retroflexion, but that it actu- 
ally causes it. 

The woman who rests on her back gives to the heavy 
body of the womb an opportunity to sink backwards, after 
the distended bladder has pushed the organ high enough up 
so that its own weight may throw it over, until it finds resist- 
ance on the posterior wall of the pelvic cavity. Many nurses 
insist on the dorsal position for days, and never permit the 
patient the privilege of lying upon one or the other side. 
Aside from the injurious effect that this has on the position 
of the uterus, it is exceedingly tiresome to be compelled to 
remain for several days in one position. Women should be 
allowed to lie on all sides, after delivery, and no longer on 
one side than on another. And to insure against a retro- 
version or flexion, she must also lie on the abdomen a cer- 
tain length of time during each twenty-four hours. 

Tight bandaging after delivery, for " preserving the fig- 
ure," greatly aggravates the displacement ; the binder should 
be so applied that it feels comfortable but not too tight, its 



VERSIONS AND FLEXIONS OF THE UTERUS. 2-")l 

purpose being to offer a gentle support to the suddenly re- 
laxed abdominal muscles, and thus stimulate them to con- 
tract to their normal form. 

The symptoms of retroflexion are greatly varied by the 
pathological conditions that affect the uterus, or by the com- 
plications that may have caused the flexion. 

It is indisputable that the uterus may be retroflected for 
an indefinite length of time without causing any inconven- 
ience. From this it may be inferred that the retroflexion 
itself does not constitute the disease, but the inflammatory 
processes, in which the organ is involved, or the relaxation 
of the adjacent structures, as we find them immediately after 
confinement, constitute the actual diseased conditions. 

One of the most constant symptoms is pain in the back, 
and this is severe in proportion to the swelling and sensi- 
tiveness of the organ, when it presses on the sacral nerves 
and rectum. 

As a result of the flexion, the circulation in the organ is 
interfered with, so that the congested uterus feels heavy, 
and there is a sensation of fullness and bearing down, that 
greatly hinders walking. Uterine catarrh and hyperemia 
place the organ in such an irritable state that prolonged 
and excessive menstruation is the rule. This may last for 
fourteen days, so that the patients become anaemic and 
greatly debilitated from the excessive loss of blood. The 
menstruation is always more painful, especially at the be- 
ginning of the flow; this pain may be interrupted or spas- 
modic, so that it assumes the form of a uterine colic; the 
lower abdominal region becomes painful and the pain radi- 
ates towards the groins. The degree of suffering is very 
seldom as great as that which characterizes anteflexion, be- 
cause the obstruction in the latter flexions are much greater 
than in retroflexions. 

Those women who have borne children suffer less pain 
during menstruation than those who have never been preg- 
nant. It may be presumed that, in the latter class, the flex- 



252 HOME TREATMENT. 

ion was congenital or acquired in early childhood, which 
makes the obstruction or constriction more complete and 
obstinate, and for that reason it induces sterility. With 
those who have once borne and afterwards acquired the flex- 
ion, the possibility of conception is much greater. 

When the enlarged and swollen body of the uterus is 
pushed backwards and downwards, it presses on the sacral 
plexus of nerves; this is a bundle of nerves that supplies 
branches to the legs, and from this pressure the lower ex- 
tremities become lame or paralyzed either on one or both 
sides. The paralysis subsides after the removal of the of- 
fending body. There is quite a number of other neurotic 
affections that can often be traced to a retroflected uterus. 
These are all of a functional nature, and appear in the form 
of hysteria, epilepsy, St. Vitus' dance and neuralgias of almost 
any part of the bod}^. Dr. Chrobak, of Vienna, reported 
a case of asthma that had resisted all the treatments that 
could be suggested, until it was finally traced to a retro- 
fleeted uterus; that being rectified, the asthma subsided. 

Irritability of the bladder is not so frequent a symptom 
of this variety of displacement as of others ; should there be 
inflammation complicating the bladder, then, of course, 
there would be considerable annoyance from this source. 

Habitual constipation is often very prominent and in 
some of the cases it is the only sign that leads to an exam- 
ination, which reveals the retroflexion. Hemorrhoids or 
piles, due to a compression of the veins of the rectum, are 
another complication included in the signs of this displace- 
ment. 

TREATMENT. 

There is a small proportion of cases in which the system 
has become accustomed to the retroflected position of the 
womb, and if the abnormal condition is rectified, a great 
many painful symptoms spring into prominence, that are 
attributable to the interference. This is particularly the 
case in women who are in those years that we term " change 
of life," and for this reason they should be let severely alone. 



VERSIONS AM) FLEXIONS OF THE UTERUS. 253 

Excluding the above class of eases, the question arises in 
other cases whether the uterus can be replaced without 
violence, or whether it is fixed or grown to its surroundings 
by inflammatory adhesions. It is not always an easy 
matter to dispose of this question at once, because the en- 
larged and congested body is often so firmly wedged down 
between the posterior pelvic wall and the vagina, that any 
attempt to dislodge it is accompanied with such acute pain 
that one feels constrained to desist for a time. "When there 
is great pain or sensitiveness, the patient should take to bed, 
so as to give the pelvic organs every chance to get rid of the 
inflammatory irritability. Hot-water compresses should be 
applied to the lower abdominal or pelvic region, and hot 
vaginal irrigations thrown into the vagina; these should be 
copious, no less than a gallon of water at once, at a temper- 
ature of 107 to 110° Fahr., repeated twice daily. The bow- 
els should be kept loose, say several operations each day, 
for three or four days; after that once a day will be suffi- 
cient. 

In the course of several weeks the congestion will have 
subsided, so that, in the great majority of cases, reposition 
can be readily accomplished. If the resistance of the womb 
still persists, then it is reasonable to infer that the organ is 
tied down by old inflammatory adhesions; these, then, 
should be treated with galvanism, after the manner described 
for removing adhesions in anteflexions. 

The statistics show that, out of every five women who 
are suffering from female diseases, one has a posterior dis- 
placement, either a retroflexion or retroversion. The great- 
est number of these are traceable to their last confinement. 
All these displacements, as well as those that are accidental 
or induced by a fall, jumps or the like, should be replaced 
as soon as possible, otherwise inflammatory adhesions may 
complicate and greatly obstruct the replacement. 

The reposition or replacement of the womb may be ac- 
complished through natural agencies, that can be employed 



254 HOME TREATMENT. 

by the patient herself. These are, in a great measure, the 
same forces to which the womb's posterior displacements are 
to be attributed, namely, intra-abdominal pressure and grav- 
itation. To employ these for the purpose of remedying the 
evil, the so-called knee-chest position must be assumed by 
the patient. The first step towards assuming this position 
is to get down on the bended knee, the thighs in a vertical 
position, then the body is gradually inclined forwards until 
one or the other shoulder touches the floor or level of the 
knee. If this position is retained for ten minutes it will 
alone replace the organ forwards, sometimes suddenly, at 
other times gradually, provided the organ is moveable and 
not squeezed into the pelvis or adhered by inflammatory ex- 
udation. 

Dr. Henry F. Campbell, of Georgia, introduced this nat- 
ural therapeutic agent into the profession, but it appears to 
be very little known or understood by the profession, per- 
haps because it is so very simple. Dr. Munde, in an article 
on " Uterine Displacement and Its Curability," in the Amer- 
ican Journal of Obstetrics, indorses the knee-chest or knee- 
shoulder position in the following language : "A moment's 
thought will demonstrate the utility of this combined vis a 
f route (gravitation of the abdominal viscera towards the dia- 
phragm) and vis a tergo (air suction into the vagina and pres- 
sure against the vaginal roof). This position is to be as- 
sumed several times daily, and maintained each time as long 
as the patient can bear it, continued for months, if neces- 
sary; the best time is at night at retiring, when the lateral 
position is to be taken for the night" 

In a certain proportion of cases the knee-chest position 
alone will not dislodge the retroflected uterus, so that man- 
ual aid is required to effect that purpose. There is a num- 
ber of methods that have been suggested from time to time, 
but none are so good as that in which the knee-chest position 
is combined with the manipulation of the operator. Reposi- 
tion may occur spontaneously, and it undoubtedly does in a 



VERSIONS AND FLEXIONS OF THE [JTEBUS, 256 

large proportion of cases, in which the retroflected organ be- 
comes pregnant. When the retroflected organ occasions 
symptoms of retention of urine, the bladder should first be 
emptied with a soft No. 8 catheter, then the patient is di- 
rected to kneel on both of her knees, her thighs remaining 
perpendicular, while her body inclines forward until one or 
the other shoulder touches the floor or level of her knees. 
The operator may then gradually lift the womb and elevate 
the body sufficiently so that it will fall forward into its nat- 
ural place. When there is no bladder trouble from compres- 
sion, and the womb resists even mild force to replace it, I 
have accomplished gradual reposition by keeping the woman 
in bed for three or four weeks, with the instructions that she 
resume the knee-shoulder position two or three times a day, 
and from five to ten minutes, also that she shall lie on her 
side and chest and never on her back. In this manner I 
have accomplished in time and without force what could 
not have been accomplished with forcible attempts without 
inducing an abortion. 

It curiously happens that there are cases of retroflection 
which are never suspected nor recognized until the patient 
has become pregnant. After the woman is about three 
months gone, the growth of the pregnant uterus can no 
longer be accommodated in the pelvis, because the direction 
of its growth is in the direction of the retroflected organ, 
namely, backwards and downwards (see Plate IV) which 
makes it a physical impossibility to escape from or grow out 
of the bony pelvis. The symptoms are retention of urine 
or a constant dribbling of urine^nd a straining at stool or 
pain in the rectum or pelvis, and, of course, the absence of 
the menses since the commencement of pregnancy. Retro- 
flection may be also acquired during the first three or four 
months of normal pregnancy, from a jump or fall on the 
back, in which all the symptoms that indicate this condition 
are suddenly manifested. 

In pregnane}^ the course that is to be pursued, in order 



256 HOME TREATMENT. 

to rectify the displacement, must be obviously different 
from that pursued when the woman is not pregnant. The 
pregnant uterus is a "touch me not;" it permits of no tam- 
pering without running the fearful risk of inducing an ab- 
ortion, and no one but a tyro or an ignoramus will ever 
meddle with the pregnant womb. 

The replacement of the retroflected uterus, that is posi- 
tively not pregnant, and there must be no question about it 
either, will admit of introducing a sound into its cavity. 
This sound is used as a lever upon which the organ may be 
lifted out of its abnormal position and inclined over the 
bladder in an anteflected position, which is its natural one. 
The sound which I employ, and which is my own invention, 
for replacing the uterus is screwed into a thimble, and from 
two and one-half to three inches long. The object of this 
is to artificially elongate the finger so that it can be intro- 
duced into the womb. The force which one employs by 
using this instrument is keenly appreciated by the operator, 
hence there can be no undue strain, that otherwise might 
be exerted on adhesions which are too strong to be safely 
lacerated or even stretched, while slight and recent adhe- 
sions might be torn without any bad results. Truax, of Chi- 
cago, manufactures my repositor. 

Before introducing any sound into the uterine cavity, it 
is absolutely necessary that the vagina should be thoroughly 
cleansed with borax water. 

The inflammatory enlargements of the womb, subinvo- 
lutions, uterine catarrhs, and any of the complications that 
may exist at the time that the organ is replaced, should be 
treated on the same principles that have been laid down in 
the respective chapters on these diseases; in fact, these com- 
plications constitute part of the after treatment for retrover- 
sion or flexion. The other treatment is to be directed toward 
retaining the womb where it naturally belongs/ The daily 
exercise in the knee-chest position should never be neglected, 
and in cases in which this is insufficient, it is very probable 



VERSIONS AND FLEXIONS OF THE UTERUS. 257 

that the pelvic floor or natural support of the uterus has 
been injured or lacerated during confinement, and this may 
require a plastic operation as a preliminary to a cure. In 
obstinate cases there is no cure so effectual as pregnancy 
and a full-time delivery, provided precautions are taken so 
that the mother will not acquire a new retroflexion during 
her lying-in period, from the cause that has been already de- 
tailed. The patient must accustom herself to sleep either on 
the chest with face turned to one or the other side, or in a 
semi-prone position on either the right or left side. Persever- 
ance in sleeping in this manner for a few weeks cultivates 
the habit that gives more refreshing sleep than lying on the 
back, which most persons are inclined to do. 



17 



CHAPTER XXI. 

DISEASES OF THE FALLOPIAN TUBES. 

The Fallopian tubes are the ovi ducts, along which, the 
sperm atozoids pass from the womb to fertilize the ovum, 
and along which the fertilized or non-fertilized ovum, as 
the case may be, is carried to the cavity of the uterus. 

They are two small canals, between three and a half and 
four inches in length, and constitute the only means of com- 
munication between the womb and ovaries ; their caliber is 
exceedingly small and lined with a delicate mucous mem- 
brane. 

The diseases which affect the Fallopian tubes are inflam- 
mation, stricture, distention and displacements. 

The inflammation is distinguished as salpingitis, from 
salpinx, Fallopian tube, and itis, in composition, inflammation ; 
this consists of a catarrhal inflammation of the lining mem- 
brane of the tubes, which rarely if ever originates in the 
tubes themselves, but is secondary to an inflammatory proc- 
ess in the neighboring organs. 

Chronic endometritis or catarrh of the womb is undoubt- 
edly the most fruitful cause of salpingitis, although this is 
not absolutely the rule, for there are some women who have 
had uterine- catarrh for years without its affecting the tubes 
in the least. But there is a type of uterine catarrh that has 
a special tendency to spread from the womb to the lining 
membrane of the tubes, and this is the infectious endome- 
tritis. An infectious inflammation of the womb may be 
due to many different sources of infection; the retained 
products of conception after an abortion may become pu- 
trescent and furnish one source ; carrying putrefactive germs 
into the uterine cavity from the vaginal canal by means of 
(258) 






DISEASES OF THE FALLOPIAN TUBE8. 259 

probes or instruments, that arc in themselves defiled by not 
having been thoroughly cleansed and purified since their 
last employment, is another source of infection; the lat- 
ter is perhaps the commoner cause of blood poisoning in 
criminal abortions by the abortionists. Gonorrhceal infec- 
tion seems to have a greater tendency than any other to 
spread itself from the uterus to the tubes; this has been the 
subject of special inquiry, and has been thoroughly con- 
firmed, and this may arise many months after the infected 
male has imagined himself entirely cured. 

The diseases of the tubes that I have enumerated are in 
the relation of cause and effect ; a catarrhal inflammation 
is quite likely to induce a stricture or an occlusion, and 
this causes a distention from retention of the secretions, 
whether the secretions are a natural or an inflammatory 
product. If the inflammation has an infectious origin, then 
the retained secretion becomes purulent, or it may be a 
muco-pus secretion from the commencement. The dilated 
tube may also contain blood or serum ; the latter constitutes 
tubal dropsy; or it may contain a fertilized ovum; this gives 
rise to tubal pregnancy. 

Tubal dropsy may be a distention of the tubes when 
both ends are sealed by inflammatory adhesions; these dis- 
tentions vary in size from the thickness of a finger to a 
large ovarian tumor, from which it is not an easy matter to 
distinguish it. 

The most dangerous form of tubal obstruction and dis- 
tention is where the contents are pus or purulent matter ; this 
is liable to be poured into the peritoneal cavity from ulcer- 
ation or rupture of the sac, and excites fatal peritonitis. 

Salpingitis can only be viewed as a complication of some 
prior inflammatory process in some of the adjacent organs 
and tissues; these are the uterus and ovaries and the pelvic 
peritoneum and pelvic cellular tissue. 

The symptoms of inflammation of the tubes are not so 
•clearly defined as to indicate the nature of the affection 



260 HOME TREATMENT. 

because it is hardly ever limited to the tubes alone, the sur- 
rounding tissue being always more or less involved. These 
patients are so seldom free from pain that their lives are a 
constant suffering. If the pain subsides, it is only for a few" 
days, and the slightest exertion brings about a relapse, so 
that walking or standing must be avoided. During men- 
struation the pain always increases, and the menses may be 
excessive at one period and scant at another ; these harass- 
ing pains make powerful inroads on the patient's strength ; 
she becomes pale and debilitated, while her emaciated form 
and careworn expression give us a picture of the typical in- 
valid. Fortunately, this complication is not as frequent as 
one might expect from the intimate relation of the tubes to 
the womb and ovaries, but the possibility of the Fallopian 
tubes becoming inflamed should admonish women against 
taking any chances by neglecting the rules of hygiene, that 
I have laid down in another chapter, for the old saying that 
" prevention is better than cure " is only too true of this 
malady. 

TREATMENT. 

The curative measures for inflammatory diseases or ab- 
scesses of the tubes have not been, on the whole, until within 
a comparatively recent period, very satisfactory. 

When this affection complicates uterine or vaginal ca- 
tarrh, then the treatment that is recommended elsewhere 
for the relief of these complaints should be adopted; quietude 
is of paramount importance, and total continence must be 
practiced by the sufferer. Hot sitz baths and warm fomen- 
tations are important auxiliaries in the treatment. Vaginal 
irrigations of hot water, night and morning, relieve the cod- 
gestion and stimulate the absorbents of the pelvic glands. 
Femina vaginal capsules are a great assistance towards ac- 
complishing the same end; one capsule introduced into* 
the vagina at bedtime should be combined with the other 
treatment. 

If these measures fail to accomplish a cure, then a surgi- 



DISEASES OE THE FALLOPIAN TUBES. 201 

cal operation may bo required as a last resort, which con- 
sists in extirpating the diseased tubes and ovaries. 

This operation has given some brilliant results, but it has 
also hurried a great many to an untimely grave. Fool- 
hardy surgeons or operators are the rule; doctors of only 
mediocre talent worm themselves into positions that give 
them prestige in the community. Where nature refuses a 
capacity for the acquirement of solid wisdom, she seems to 
compensate her creatures by endowing them with faculties 
for cunning and intrigue, that galvanize the spurious into 
the apparently genuine. They have charge of hospitals 
and are professors in colleges, and are ambitious to imitate 
the operations of the European masters. On the other 
hand are the statistics of able surgeons, who seem to have 
an inborn genius for a special line of operations; such a one 
is Lawson Tait, of Birmingham, and Martin, of Berlin. 
Tait has had phenomenal success in cutting open the 
abdomen and removing diseased tubes and ovaries. He 
possesses the faculty and skill to select only those cases that 
are especially suited for an operation, and those that are not 
adapted for the knife are excluded. In the exercise of this 
judgment the danger of the operation is reduced to a 
minimum. The tubes and ovaries are often so matted and 
tied down with inflammatory adhesions, that their removal 
means sure death, and does the average surgeon know this? 
To have the genius of a Tait is to be one in ten thousand, 
and for this reason his statistics should be neither a guide 
nor an excuse for the other nine thousand nine hundred 
and ninety-nine, to attempt to do as he does. To assume 
that they can, is as absurd as to admit that our indigenous 
colonels of the State militia can plan or execute the cam- 
paigns of Napoleon. 

Galvanism or electricity has come to the rescue of this class 
of cases, as a safe and reliable method of treatment; of 
course it takes more time and patience. Should not this 
outweigh the selfish ambition of the unscrupulous surgeon 



262 HOME TREATMENT. 

who desires to boast of the number of times he has opened 
the abdomen, with little compunction of the confiding lives 
that he has sacrificed? 

I have myself had abundant experience to be convinced 
of the usefulness of electricity as a curative agent in this class 
of diseases, but I prefer to illustrate the treatment by quot- 
ing from a paper on " The Value of Electricity as a Substi- 
tute for Laparotomy," by Augustin H. Goelet, M. D., in the 
New York Medical Journal. He says: — 

" Mrs. T., aged twenty-six. Severe pelvic pain referred to 
left side ; profuse leucorrhoea ; prolonged and painful men- 
struation. Diagnosis: Pyosalpinx (or pus) in the left tube. 
Laparotomy (opening the abdomen) advised at Woman's 
Hospital. Treatment: Tube emptied into the uterus by 
applications of positive galvanism to the left horn of the 
cavity of the uterus. Intravaginal applications afterwards- 
completed the cure. Duration of treatment, four months 
Complete relief of pain followed the removal of the pus from 
the tube. At the end of the treatment she had completely 
regained her health. Menstruation was normal, and symp- 
toms relieved." 



CHAPTER XXII. 

DISEASES OF THE OVARIES. 

There is an analogy in the reproductive apparatus, run- 
ning through the whole animal and vegetable kingdoms. 
The bulb at the lower extremity of the pistil of a flower is 
called the ovary, and it contains the seed, which in the 
course of development becomes the fruit. 

In the human female, the ovary contains the seed, or germ, 
which, becoming fertilized, develops into the human embryo, 
or the fruit of conception. 

The seeds of the ovaries are termed ova, or eggs, and the 
organ or gland in which the germs, or eggs, are prepared is 
the ovary. 

In the human female the ovaries are two follicular 
glands, about the shape and size of small almonds, situated 
on each side of the uterus. The follicles, or small sacs, of 
which the ovaries are composed, are cemented together by 
delicate fibrillar connective tissue, which is known as the 
stroma of the ovary, while the follicle is termed Graafian 
vesicle, after the name of its discoverer. Professor Barry, 
another investigator, gave the follicles the much better and 
more appropriate designation of ovisacs, because each of 
these capsules or follicles contains a single ovule, or little 

egg- 

It is carefully estimated that there are 30,000 Graafian 
follicles or ovisacs in each ovary, of which only an in- 
significant number develop and rupture at each menstrual 
period. It appears, from the researches of Valentine and 
Pflueger,that the Graafian follicles are formed at a very early 
period of embryonic life, from a series of minute tubules, 

(263) 



264 HOME TREATMENT. 

that gradually become constricted from surrounding stroma, 
at regular intervals ; the ova are subsequently developed in 
the interior of the follicles. 

Ovarian cysts or tumors cannot be considered in a work 
for home treatment, but a desire must be awakened in the 
minds of thoughtful readers, to learn the origin of these 
growths, and it seems to me quite appropriate at this juncture 
of the subject, to state that Professor Waldeyer, of Berlin, 
has discovered that ovarian tumors are developed from the 
remnants of the little tubules from which the Graafian 
follicles originate, so that the cause or source of these tumors 
is already laid before the patient is born; hence cannot be 
attributed to any fault on the part of the afflicted person. 
From the earliest period of intra-uterine development up to 
the age of puberty, the growth of the ovaries is entirely 
passive, but after that a continuous change takes place in the 
substance of the ovaries ; the contents of the ovaries become 
active from the period of puberty, from which dates the com- 
mencing aptitude for procreation, until the menopause, or 
final cessation of the menses, which, in popular language, is 
termed " change of life," when the aptitude for conception 
ceases with the proliferation of the ova. 

The period of fruitfulness is characterized by the persist- 
ence of the menses, and this terminates, on the average, in 
the forty-fifth year; during all of this time the little ova, or 
eggs, continually ripen, and at their maturity the ovisacs, or 
Graafian vesicles, rupture from an increased secretion into 
their cavities. This ripening of an egg and rupture of a 
follicle corresponds with the monthly flow. The human 
ovum is very small; the largest does not measure above 
l-120th of an inch in diameter, and very often it measures 
only half that size. 

The situation of the ovary is not fixed in the pelvic 
cavity with any absolute degree of certainty, but it enjoys 
a degree of mobility that is even greater than that of the 
womb itself, to which it is attached by means of the ovarian 



J 
DISEASES OF THE OVARIES. 265 

ligament. Its usual place is about an inch from the uterus 
and a little backwards. It is partly surrounded by folds 
of peritoneum, and partly by the tissue that pads out the 
interspaces between the pelvic organs. If we remember the 
physiological fact, that at every monthly discharge of blood 
from the uterus, which is called menstruation, an ovum or 
egg ripens and an ovisac bursts, we cannot fail to appreciate 
the importance of the intimate relations that these functions 
must have, to the health of the individual and the jDerpetua- 
tion of the species. 

This process of ovulation has the peculiarity of the first 
stages of an inflammatory action, because the ovaries be- 
come congested whenever an ovisac ruptures. 

Through the nervous sympathy existing between the 
ovaries and uterus, this too becomes congested, so that the 
network of uterine vessels becomes so engorged that the 
capillary blood vessels of the mucous membrane of the 
womb rupture, and the hemorrhage that is the result con- 
stitutes the menstrual flow. 

There are three physiological processes concerned in the 
menstrual phenomena: first, irritation and congestion of the 
ovary, rupturing the ovisac; second, congestion of the Fal- 
lopian tubes and uterus ; third, consequent rupture of the 
blood vessels of the mucous membrane of the uterus and 
probably of the Fallopian tubes. 

There may be one or more supernumerary ovaries with- 
out disturbing the normal functions; one or both ovaries 
may be congenitally absent. The entire absence of both 
ovaries is generally accompanied by deformities of so seri- 
ous a nature that the newly-born infant is incapable of living. 

If the defect is principally limited to congenital absence 
of the ovaries, then there is an absence of the changes in 
wdiich puberty is recognized; the mammary glands remain 
flat; there is not the roundness and fullness of the girl's 
figure that signalizes budding maidenhood. The apparently 
undeveloped form and girlish characteristics are prolonged 



266 HOME TREATMENT. 

into the years of adult age, and she remains weakly and 
small. 

In an incomplete or rudimentary development, from an 
arrested or imperfect evolution of the ovaries, there is often 
a condition that resembles the above very much; neither are 
these cases nearly so infrequent as those whose organs are 
entirely absent. The ovaries may persist in their fetal 
state, or their growth may be arrested at any time before the 
expected period of puberty. The diagnosis of this patho- 
logical condition must be inferred from the undeveloped 
state of the different organs and from the absence of those 
signs which the approach of the menses communicate. 

Displacements of the ovaries are often the cause of suffer- 
ing and disease, that may excite symptoms quite remote 
from the seat of trouble. I remember the case of a young 
woman, who had suffered from obstinate dyspepsia, which 
subsided at once after the removal of the prolapsed ovary. 
It has been already alluded to, that these glands are naturally 
very movable. Anything which increases their weight, 
whether inflammatory enlargement or a dragging in con- 
nection with some inflammatory adhesion to a neighboring 
organ, may cause their displacement in various directions. 
It happens that the ovary may form the contents of a 
hernia or rupture. A prolapse or descent is the most com- 
mon form of an ovarian displacement. We often find one 
or the other ovary resting in the pouch between the uterus 
and rectum, and if the patient should be troubled with con- 
stipation, the hardened feces may give rise to painful symp- 
toms in the ovaries, and pain in the rectum, while it also is 
one of the causes of painful sexual relations. The irritation 
to which the dislocated ovary is exposed gives rise to in- 
flammatory affections, that may be the cause of continual 
suffering. 

INFLAMMATION OF THE OVARIES, OR ACUTE OVARITIS. 

What inflammation is elsewhere, it is again here in 
these glandular structures. 



DISEASES OF TIIK OVARIES. 267 

I endeavored to point out in the beginning of these arti- 
cles, that the difference of inflammatory diseases was not 
due to any difference in the inflammatory processes, these 
are identical, but the modification of the processes are due 
to the nature of the structure of the tissues that are involved. 

If the intelligent reader will bear this in mind, she will 
form a clear idea of all the inflammatory diseases that come 
under consideration. 

Pathological microscopists have recognized two forms of 
ovaritis, the follicular or parenchymatos, in which the 
Graafian follicles or ovisacs are the seat of the inflammatory 
process, and the interstitial, in which the intervening or 
interstitial connective tissue, the stroma, between the follicles 
is inflamed. This distinction has only a scientific interest 
because it is impossible to distinguish one variety from the 
other in the living subject; this can only be done with the 
aid of a powerful microscope after the suspected ovary is 
removed from the body. Whether the inflammation is 
follicular or interstitial or both combined, it is liable to de- 
stroy all the follicles or ovisacs which contain the ova, that 
are essential to procreation, and the consequence will be 
sterility. 

The great functional activity to which the ovaries are sub- 
jected at each menstrual period, make them extremely liable 
to an inflammatory process, so that women cannot be too 
careful of themselves at this precarious period. It is during 
menstruation that the ovaries become periodically congested, 
and this alone offers an excellent predisposition for inflam- 
mation. As a complication of other inflammatory diseases, 
ovaritis is very common; it seems hardly probable that 
there can be an inflammation of a pelvic peritoneal fold or 
of the pelvic cellular tissue in close proximity to or sur- 
rounded by it, without involving the corresponding ovary. 
There cannot be a serious inflammation of the womb or of 
the Fallopian tubes without being communicated to the 
ovaries, and this is always true of the infectious catarrhs, 
especially the gonorrhoeal form. 



2G8 HOME TREATMENT. 

There is a great tendency in inflammation of the ovaries 
to suppurate and change the entire tissue of the ovary into 
an abscess. Ovarian abscesses are not much different in 
their behavior from abscesses in the Fallopian tubes or 
cellular tissue. It is claimed that they have a greater 
tendency to break into the bladder than other pelvic 
abscesses; this may be due to a displacement of the ovary, 
which locates the gland near or between the bladder and 
uterus, before the advent of the inflammation. There are 
no infallible signs that point to the existence of acute in- 
flammation of the ovaries, owing to the complication of 
other inflammatory processes in the majority of cases. The 
characteristic pain of an inflamed ovary is of a throbbing 
or pulsating nature. 

I cannot imagine an ovaritis without at least a circum- 
scribed peritonitis, and one can hardly suppose a pelvic 
peritonitis to exist without in a certain degree compromising 
the ovary. 

If the ovary has once become inflamed, whether alone 
or as a complication of other diseases, then the most im- 
portant question to decide is the existence of an abscess- 
This can only be recognized by an experienced and careful 
specialist, who has trained his sense of touch, so that he 
can feel the abscess between the fingers of one hand in the 
vagina, and the other making counter pressure on the 
abdomen. The history of each case must in a measure de- 
cide the nature of the fluctuating tumor, whether it may 
not be an ovarian cyst instead of an abscess, although an 
abscess may have been a small cyst. 

The development and course of different cases, present 
various aspects for consideration. The enlargement may 
become obstinate to the ordinary methods of treatment and 
assume the chronic form of subacute inflammation. The 
inflammation may spread from the ovary to the peritoneal 
membrane that partly covers it ; these are the broad liga- 
ments of the uterus. This may be the means through 



DISEASES OF THE OVARIES. 2fi9 

which the organ may grow to the surrounding tissue and 
adjacent organs, so that it becomes utterly impossible to 
move it or even successfully extirpate it from its intimate 
attachments. 

In other cases the ovary remains entirely free from at- 
tachments or complications, and while it can be generally 
felt lower down pressing perhaps on the rectum, it is read- 
ily movable or replaced. In the majority of cases only one 
ovary is involved, but in these cases there is a predisposition 
which in a large proportion sooner or later compromises 
also the other ovary in a similar diseased process. 

TREATMENT. 

The treatment of this affection is greatly modified or in- 
fluenced by a knowledge of the causation of the inflamma- 
tion. In every case, however, the patient should take to 
her bed. If there is a profuse vaginal secretion it should 
be ascertained if the disease is of infectious origin, and 
where this is suspected, the vaginal canal should be thor- 
oughly rinsed with an antiseptic solution of corrosive chlo- 
ride of mercury in the proportion of one grain of the sub- 
limate to two thousand grains or parts of water, or about 
fifteen grains to the half gallon of water. There are tablets 
to be had at the drug stores which contain the requisite 
amount of corrosive when added to a given quantity of water; 
these are preferable and more convenient than the crude 
drug, and as they are a deadly poison they should be kept 
under lock and key. There is nothing to equal the corro- 
sive for an offensive vaginal discharge, for it is the most re- 
liable disinfectant there is in the entire pharmacopoea. Half 
a gallon of this solution should be used at a time, and after 
the vaginal canal has been thoroughly disinfected, about a 
pint of the same solution must be passed through the uter- 
ine cavity by means of a double catheter, that has a reverse 
flow and is especially made for the purpose. To insure 
against mercurial poisoning I am in the habit of following 



270 HOME TREATMENT. 

mercurial irrigations with warm water, that was previously 
sterilized by boiling. One pint of the simple water is gen- 
erally sufficient to displace all the mercurial water that 
might have remained in the uterine or vaginal cavities. 
These medicated irrigations should have an average temper- 
ature of 105 degrees Fahr. and be repeated daily for about 
a week. 

If the vaginal secretion is not of a specific nature, then 
the Femina antiseptic uterine lotion is a safer remedy. 

Ice bags applied over the regions of the painful ovaries 
check the acute inflammation from going into suppuration 
and forming an abscess. Should the latter be found to exist, 
it should be opened by means of a trocar or aspirator. The 
bowels should be kept free by taking a daily dose of Femina 
laxative tablets. 

CHRONIC OVARITIS. 

If an acute inflammation does not terminate in prompt 
recovery or an abscess it may lose its fiery nature and tone 
down into a low grade of prolonged congestion which does 
not go on to the production of suppuration. This would 
constitute the chronic form of inflammation. 

It does not follow that all chronic inflammations are pre- 
ceded by the acute form, for there are inflammations that 
are subacute from the beginning, that is, that there is not 
the heat nor feverishness in the tissues which is one of the 
principal features of the acute process. 

Chronic inflammation of the ovaries is much more fre- 
quent as an original or individual affection, than the pre- 
ceding form. A peculiar feature of this affection is a grad- 
ual growth or enlargement of the ovary, all the way from a 
moderate swelling to a good-sized orange. There has been 
some discussion as to the particular tissue of the ovaries 
that is involved in the inflammatory process, whether it is 
the interfollicular structure or the follicules or ovisacs them- 
selves ; practically the solution of this question has no bear- 



DISEASES OF Till: OVARIES. 271 

ing on the treatment, although it may have an influence on 
the function of the organ, which may be more injuriously 
affected by the latter than the former variety. The disease 
occurs almost exclusively after the age of puberty and dur- 
ing the period of sexual activity. It is not as often met in 
the unmarried as in the married, and with the latter it is 
more prevalent in the first years of married life. Inordi- 
nate sexual indulgence is a frequent exciting cause, and 
when this is coupled with pernicious means that are em- 
ployed for preventing conception, it becomes still more fre- 
quent. 

Chronic inflammation of the vagina, womb, and of the 
Fallopian tubes is often transferred to the ovaries. 

The infectious catarrh to which the genital tract of the 
female is more or less exposed from a lack of proper clean- 
liness of her own person, or a gonorrhceal infection from 
her male companion, show a peculiar tendency to gradually 
spread the inflammatory processes to the ovaries. Some 
careful observation has established the fact that an appar- 
ently cured gonorrhceal infection in the male may, after a 
year or two, excite a gonorrhceal catarrh in the genitals of the 
female; a great many diseases of the ovaries have been 
traced to this source of infection. 

As gonorrhoea is not an uncommon affection among the 
male portion of the community, it is not sufficient for the 
intelligent members of the medical profession to know of 
these dangers of infection, but every man and woman should 
be apprised of the great danger there is of infecting the 
marital chamber with the pollution of the brothel. 

The symptoms of chronic ovaritis are more or less de- 
pendent on the causation of each individual case. 

Sometimes it is traced to the fiery stage of the acute af- 
fection, while in other instances it can be laid to some indis- 
cretion during the menstrual flow, then, again, it may have 
developed itself so stealthily that the greatest acumen and 
skill are required to detect its origin. The most important 



272 HOME TREATMENT.; 

and constant sign is a steady pain in one or both ovaries. 
When this pain is violent, it shoots toward the back and 
rectum and down the thighs. The pain becomes height- 
ened from an accumulation of feces in the rectum, which a 
habitual constipation entails. Marital excesses near the ap- 
proach of the menstrual period or shortly after the disap- 
pearance of the menses are quite likely to precipitate the 
painful symptoms. The bladder sympathizes in a certain 
proportion of cases, so that there is a frequent desire to pass 
water. In the course of time the distressful symptoms that 
have been enumerated derange the digestive apparatus ; the 
patients lose their appetite and decline into a debilitated and 
nervous state, so that one or the other hysterical phenome- 
non become more or less prominent in persons of a nervous 
temperament. 

Sterility is a rule with this class of women, even if there 
is only one ovary affected ; this would indicate that the ap- 
parently healthy one sympathizes with the other, or an ac- 
companying catarrh of the uterus or tubes may prevent the 
passage of the fertilizing germ. If both ovaries are inflamed, 
then it is quite natural to suppose that the delicate follicles 
and their contents, the ova, become destroyed or so altered 
that they no longer answer the purpose of reproduction. 
It is seldom that one meets a chronic ovaritis without a 
uterine catarrh, and how much this contributes to the ste- 
rility is not easy to tell. 

TREATMENT. 

The course of this affection in the majority of cases is 
favorable. If the treatment is intelligently administered, 
the pain and congestion gradually subside, and as this class 
of patients have generally learned from sad experience that 
negligence or indiscretion on their part will excite a relapse, 
they soon learn to avoid these, so that they enjoy compara- 
tive immunity from suffering for a considerable length of 
time. 



DISEASES OF THE ova i: li:s. 273 

There is a smaller proportion of cases whose unfortunate 
surroundings or lack of intelligence makes remedial meas- 
ures of no avail. These poor women have neither respite 
from physical labor nor freedom from the animal passions of 
their husbands, and thus living in constant pain they be- 
come drooped in spirit and reduced in vigor, so that they 
fall an easy victim to any intercurrent affection that may 
attack them. 

In proportion as the patients can give their diseased 
ovaries freedom from irritating influences are the chances 
for their complete recovery increased. 

To accomplish this object, quietude in the recumbent 
posture, sexual abstinence and a free daily stool form the 
basis for recovery. If there is much pelvic pain, this is best 
controlled by means of the ice bag, 4x6 inches in size, of 
which one on each side, wrapped in one thickness of flannel, 
should be applied to the groin or region of the ovaries; 
cold-water compresses, thoroughly wrung, so as not to drip, 
and covered with flannel so as to keep the bed covering dry, 
are also advisable, but only a poor substitute for the ice. 

Iodoform suppositories greatly stimulate the absorption 
of the inflammatory exudation; one of these should be in- 
troduced into the vaginal canal each day. If the patient 
can get up without any painful symptoms, she should take 
the hot sitz bath for ten or fifteen minutes daily, and as a 
general tonic, this is a useful prescription. 

NO. XI. 

Take: Bromide of sodium 2 drams 

Iodide of potassium 1 dram 

Comp. tinct. of gentian 2 ounces 

Water, sufficient to make 8 ounces 

Mix. A tablespoonful three times a day. 

There is no affection in the entire category of diseases of 
women, in which the confidence of women has been more 
abused by specialists, than by meddlesome surgical inva- 
sions, for the extirpation of one or both ovaries, to cure real 
18 



274 HOME TREATMENT. 

or imaginary diseases of these glands. There is a veritable 
mania among surgeons for this operation, but the conserva- 
tive portion of the profession are awakening to a conviction 
that this is entirely wrong, and a presumption on profes- 
sional license that is altogether unpardonable. 

If these castrations were confined to the removal of 
ovaries that are unmistakably degenerated or diseased, and 
that had resisted intelligent treatment for some time, there 
would not be the same objection, but when ovaries are re- 
moved that are apparently healthy, but through ignorance 
or incompetency are supposed to be the offending members, 
then, I say, that is an outrage. 

There are a great many women who have been subjected 
to the dangers of a so-called normal ovariotomy, without be- 
ing in the least benefited by the operation. The symptoms 
which the extirpation of their ovaries was to relieve, per- 
sisted as before, and they discovered, when it was too late, 
that spaying is not a panacea for the ills that suffering 
women are heir to. 

The ovaries are in delicate sympathy with all the other 
pelvic organs, and when these are affected there may be 
more or less pain in one or both of these glands. They 
may be even the seat of a neuralgic affection without any 
structural change in the organ or in the neighboring or- 
gans. This would be simply a reflex sign of a general de- 
bilitated condition, and to mistake all these for ovarian 
disease and to make it an excuse for their removal, is not 
warranted by careful observation. Electricity is now com- 
ing to the front as one of the most valuable remedies for 
just this class of affections, and I will give a detailed ac- 
count of the nature of this remedy and the requirements for 
its successful application, which persons who speak lightly 
of its virtue, never acquire nor take the pains to possess. 



CHAPTER XXIII. 

PERIMETRITIS AND PELVIC PERITONITIS. 

The peritoneum is a delicate, thin, serous membrane, 
that lines the whole internal surface of the abdomen and 
envelopes more or less completely all the abdominal organs, 
so that the viscera glide smoothly against each other with 
the least possible friction. The peritoneum dips down al- 
most midway into the true pelvis, and its boundaries con- 
stitute also the limit of the abdominal cavity. That portion 
of the general peritoneum, which partly invests all the 
pelvic organs, is distinguished from the other by the term 
pelvic peritoneum. When the entire membrane becomes the 
seat of inflammation, the affection is a general peritonitis, 
but when the inflammation is limited to the organ that it 
infolds, the prefix peri, signifying around, is compounded 
with the name of the organ, and the suffix it is is added, 
which indicates that the peritoneal covering of such an 
organ is inflamed, hence, the term peri-metra-itis means 
inflammation of the peritoneum around the womb. 

Pelvic peritonitis means that the peritoneum of the en- 
tire pelvic cavity is involved in the inflammatory process. 
This may include the peritoneal covering of all the other 
pelvic organs besides that of the womb as well as the peri- 
toneal folds, that enter into the formation of the broad and 
other ligaments of the pelvic organs. 

Perimetritis is rarely an independent uncomplicated dis- 
ease, but oftener a complication of inflammation of the 
womb, the Fallopian tubes, ovaries, or of the cellular tissue 
that surrounds the organs and in which they are imbedded. 
The pelvic peritoneum and the cellular tissue are so inti- 

(275) 



276 HOME TREATMENT. 

mately connected with each other by means of their ves- 
sels, nerves and lymphatics, that an inflammation easily 
runs from one tissue to another. 

If we now inquire into the causes which induce this dis- 
ease, we shall find that there is not a single inflammatory 
disease of any of the pelvic organs that may not lead to its 
inauguration. Metritis after an abortion or a confinement 
is a fruitful source, so are all the other causes that operate 
in exciting metritis indirectly concerned in this affection. 
Since etiology or the causation of diseases has been made a. 
special study in connection with this subject, some startling 
discoveries have been made in regard to the origin of pelvic 
peritonitis. 

Dr. Noeggerath, of New York, has found in the majority 
of cases that came under his observation, that pelvic peri- 
tonitis, either acute or chronic, is due to gonorrheal in- 
fection. He claims that gonorrhoea in the male is in tlie- 
majority of instances incurable; although it may be appar- 
ently cured, it continues as a latent affection which regularly 
infects his female companion. This shows itself at first as 
a slight vaginal catarrh, which gradually and stealthily 
spreads to the cavity of the womb, thence to the Fallopian 
tubes and ovaries and afterwards involving the pelvic peri- 
toneum, for it must be remembered that the Fallopian tubes 
open directly into the peritoneal cavity. 

Dr. Noeggerath has collected statistics that agree with 
those of the celebrated French physician, Bicord, which 
show that on an average 80 per cent of the male population 
have had gonorrhoea, and, believing themselves cured, when 
not, enter into married relations, and unwittingly infect their 
wives. He says that " it has come to pass that young ladies 
dread to marry, because all their friends become invalids 
soon after the nuptial rites." The late Professor Schroeder, 
of the Berlin Gynecological clinic, says that "the assertions 
of Noeggerath are extravagant, but that he must particularly 
emphasize that chronic inflammatory conditions of the in- 



PERIMETRITIS ANT) PELVIC PERITONITIS. 277 

ternal female genitals, like catarrh of the vagina and uterus, 
metritis and perimetritis, are extraordinarily frequent results 
of gonorrlioeal infection." 

I am inclined to think, from my own experience, that the 
more conservative view of Professor Schroeder is perfectly 
safe and true, but if Dr. Noeggerath made due allowance for 
the number of invalids among newly-married people whose 
uterine diseases, especially pelvic peritonitis, were traceable to 
criminal abortions and monthly probing of their uterine 
cavities to induce the menstrual flow, his views would about 
coincide with those of the distinguished Berlin authority. 
These catarrhal affections cause sterility, and if conception 
supervenes, then there is a likelihood of a miscarriage or a 
premature birth, or a perimetritis during pregnancy or con- 
finement. 

Menstrual disorders in which the flow is either obstructed 
or suppressed may also give rise to perimetritis. 

Blood poisoning from criminal operations contributes its 
share in the causation. Trumatic agencies, like blows, falls, 
lacerations, and other injuries during labor, may result in 
pelvic peritonitis. 

Either too hot or too cold vaginal irrigations have given 
rise to this affection, and injections into the cavity of the 
womb for medicinal purposes, in which some of the fluid 
escaped through the Fallopian tube into the peritoneal cav- 
ity, has caused, in several instances, fatal peritonitis. The 
inflammation of the womb after childbirth invariably in- 
volves the peritoneum. The course and duration of this 
disease is by no means uniform. 

The disease under consideration is an example of an 
acute inflammation affecting a serous membrane. 

I have taken pains to inform the reader that the phe- 
nomena of inflammation are always the same, but that the 
results are modified by the peculiarity of the structure of 
which the tissues are composed. 

A serous membrane differs completely from a mucous 



278 HOME TREATMENT. 

membrane, inasmuch as it contains neither mucous glands 
nor mucous cells, and for that reason can never be the seat 
of catarrh ; instead of this, it possesses the power to secrete 
or transude the serous portion of the blood, hence its name. 
The serous membrane in a healthy condition has only a 
sufficient quantity of secretion to moisten the membrane,, 
but not to furnish any appreciable quantity of fluid. If the 
secretion takes place as a result of congestion, especially 
when this congestion is due to an obstruction to the return 
of blood from heart or liver disease, it is secreted in such, 
large quantities that it constitutes dropsy. 

Under the stimulating influence of the inflammatory 
process, a similar secretion is the result, only that it contains 
also fibrin, which renders the secretion or exudation sponta- 
neously coagulable, and, further, possesses the capability of 
passing into the condition of an organized tissue, either 
fibrous or granular, and thus forming false membranes on 
inflamed surfaces, or solidifying into tumors or swellings. 

These inflammations have their various degrees of sever- 
ity, from a temporary reddening of the membrane with 
barely enough effusion of inflammatory material to cause a 
thin layer of deposit, to extensive and violent attacks, that 
pour out enormous quantities of effusion or exudation, so as 
to fill the entire pelvic cavity with a solid mass. The na- 
ture of the inflammatory material may be purulent from the 
beginning, because its origin was of an infectious or septic 
nature. 

Suppuration ma}^ develop slowly and lead to an abscess; 
this may open or break into the peritoneal cavity, causing 
general septic peritonitis, which will cause death in a few 
hours or days. The abscess may also suppurate and break 
into some of the adjacent organs or tunnel its way in dif- 
ferent circuitous routes, being guided in its course by the 
pelvic and muscular fasciae, so that it may perforate at the 
groin, show itself at the inside of the thighs, or in the lum- 
bar region near the kidneys. It ruptures most frequently 



PERIMETRITIS AND PELVIC PERITONITIS. 279 

into the rectum, next in frequency into the vagina and into 
the bladder. I had a case, that came under my treatment, 
in which both rectum and vagina were perforated, and puru- 
lent matter discharged from both fistula); under appropriate 

treatment the patient recovered completely. 

If the inflammation is not of infectious origin, the exu- 
dation gradually becomes absorbed, and each day grows less, 
until finally nothing but a few fibrous bands can be felt, and 
these too may disappear in time. 

The symptoms of perimetritis depend in a great meas- 
ure on the nature and severity of the attack. 

There are three distinct stages of this disease, and each 
has its characteristic symptoms. The first stage is that of 
inflammatory congestion, which is generally ushered in with 
a distinct chill or a chilly feeling, which is speedily followed 
by a high fever and a rapid pulse. The lower abdominal 
region becomes exceedingly sensitive and very painful on 
pressure; the abdomen becomes tympanitic or bloated, and 
it is a relief for the patient to draw her limbs up, so as 
to relax the abdominal walls. A vaginal examination in 
this stage gives only negative results; there is nothing but a 
painful sensitiveness, great heat, and the vaginal walls are 
puffed or swollen; there is as yet no inflammatory exuda- 
tion that can be felt by the finger. 

After the affection has lasted one or more days, the sec- 
ond stage of the disease is recognized, this is the effusion or 
exudation. The characteristic physical signs of effusion are 
the only absolute proof of the existence of this disease. 
These signs are (1st) an immovable fixed state of the womb, 
which is quite the contrary to its natural healthy state, that 
permits of a mobility in all directions; (2d) a hard, non- 
bulging condition of the tissues that surround the womb, so 
that the impression which one receives gives the idea of all 
the pelvic organs being cast or set in wax, because everything 
is glued down and immovable; (3d) an indistinct fullness is 
felt by the patient, high up in the pelvis; this is the free 



280 HOME TREATMENT. 

exudation of the inflammatory material, which has now be- 
come solidified and has some characteristics of a tumor. 
This may push the organ forward or to either side or sur- 
round the womb on all sides. 

The third stage is that of absorption or the gradual dis- 
appearance of the exudation ; this is usually a slow process, 
and may take from three to six months. I have known res- 
idues of the exudation, in the form of fibrous bands or adhe- 
sions or solid lumps to remain for years in the pelvic or 
peritoneal cavity. These bands may tie or fix the uterus to 
the rectum or to the pelvic walls, so that it will resist all or- 
dinary efforts to replace it. Pelvic hematocele, or an effusion 
of blood into the pelvic peritoneum, inclosed either by ana- 
tomical structures or previously-existing inflammations, 
greatly resembles the sero-fibrinous exudation of perimetritis. 
The pallor of the countenance aided by other signs of hem- 
orrhage must assist in distinguishing the affections. 

Chronic perimetritis is developed in numerous affections 
of the womb that exert a continuous irritation of its peri- 
toneal covering. These are fibroid and malignant tumors, 
painful and difficult menstruation, as well as enlargement 
of the tubes and ovaries. Inflammation of the uterus and 
a discharge of blood or matter through the tubes and into 
the peritoneal cavity, may bring about a chronic pelvic 
peritonitis from the beginning. 

Chronic perimetritis or chronic pelvic peritonitis, for the 
terms are often interchangeable, is most abrupt in its de- 
velopment, because it is not heralded by fiery, acute febrile 
symptoms, but a close inquiry will usually recall to the 
minds of patients the commencement of the trouble. The 
fact that the peritoneum is also reflected on the bladder, 
causes an irritability of this organ, to be the first and only 
symptom, for quite a while. There is nothing stereotyped 
in the development of any disease, so that the symptoms 
may or may not be painful from the beginning. The pains 
in the pelvis are more or less continual, there is an incapacity 



PERIMETRITIS AND PELVIC PERITONITIS, 281 

for bodily exertion, the bowels are out of order, either there 
is constipation or a chronic diarrhoea; these morbid condi- 
tions destroy the appetite and the patient becomes lean and 
weakly. From time to time all these abnormal signs be- 
come aggravated, so that the sufferer may be forced to take 
to her bed. 

Some women have great powers of resistance and endure 
suffering with great fortitude, so that they are compara- 
tively free from harassing pain, although their pelvic organs 
are tied down by inflammatory adhesions, and unless they 
lift or make other unusual muscular efforts, that increase 
the intra-abdominal pressure, so as to drag on the adhesions, 
they suffer little or no pain. Another sign of chronic peri- 
metritis is painful intercourse, which jars the adhesions, 
and this is particularly the case if the womb comes down 
quite low. The danger to be apprehended is that no one 
knows at what moment some indiscretion will light up an 
acute attack with all its serious consequences. 

In view of the possibility of any local or circumscribed 
peritonitis becoming general, and as such may prove fatal, 
the importance of recognizing it in its first stage, or early, 
becomes readily apparent. 

Preventive measures of circumscribed or local peritonitis 
are to be found in avoiding the causes that have been referred 
to as inducing the affection under consideration, among 
which, criminal abortions are the most fruitful. It seems to 
me that if women were cognizant of the dangers that threaten 
them, they would not only be more careful in observing the 
ordinary rules of health, but they would voluntarily shrink 
from committing crimes that not only stain their souls with 
the blood of their own kindred, but also entail disease and 
death, that unexpectedly waft their spirits into the presence 
of their Creator, whose laws they have outraged. How 
often have I been told by women who lay prostrated on 
their death bed, "0 doctor, I did not know that the in- 
duction of an abortion was a crime and dangerous, because 



282 HOME TREATMENT. 

the person who performed the operation told me that it was 
neither dangerous nor criminal." Alas ! poor woman, there 
is no greater crime, and nothing more pernicious to your 
health and life ; would that others would only learn and profit 
from the inexorable fate into which your delusions enticed 
you. 

TREATMENT. 

The treatment in this affection, when prompt and intelli- 
gently administered, offers every chance of success. In the 
acute stage of pelvic peritonitis, we must resort to remedies 
that promptly conteract the inflammatory action. The in- 
ternal administration of opium or some morphine prepara- 
tion is invariably demanded, not only to relieve the pain 
but also to completely check or constipate the bowels, so 
that their peristaltic action is entirely suspended, for their 
motion would irritate the peritoneum. Dr. McMunn's 
elixir of opium in one-half to one teaspoonful doses should 
be given every four hours, until the pain is relieved and 
the bowels controlled. 

Rubber ice bags should be applied to the lower abdomi- 
nal region. This course of treatment will generally limit 
and check the inflammatory process in a few days; then the 
bowels should be gently moved every day, with an enema of 
warm water impregnated with a little soap; after which,, 
complete quietude in bed for another week or two, will com- 
plete the cure. 

Chronic perimetritis must be treated according to its 
complications; should there be a gonorrheal infection, then 
what was said of the treatment of this complaint elsewhere, 
applies with equal force to these cases. The patient's strength 
must now be an object of jealous solicitude. .The diet must 
be of the most nourishing nature, and milk or egg punch 
should be the principal food, at regular intervals of four 
hours, alternating with strong soups or beef teas, to which a 
raw egg thoroughly beaten should first be added. 

Vaginal and uterine catarrhs, if they exist, require the 
attention that is recommended in the preceding pages. 



PERIMETRITIS AND PELVIC PERITONITIS. 283 

Warm compresses or fomentations and daily hot sitz 
baths are of great value in chronic perimetritis, for they 
stimulate the healing process and the absorption. The 
bowels must now be daily moved, and here I prefer the 
patient to employ simply warm water enema in tolerably 
large quantities slowly injected, until a quart or more of 
the fluid has been thrown into the rectum; these enemas will 
not only move the bowels, but also stimulate the healing 
process. If the patient lies on the left side while these in- 
jections are taken or given, the enema flows higher up, and 
it should be retained for a reasonable length of time. 
These enemas should only be taken every other day, and 
between days a suitable dose of purgative elixir. Tincture 
of iodine can be applied to the groins every second day, or 
iodoform suppositories introduced into the vagina. Mud 
baths are also very beneficial in removing old inflammatory 
adhesions. 

If the exudation suppurates and an abscess forms, it 
should be freely opened as soon as possible. This can gen- 
erally be best accomplished through the vagina, but if there 
be a tendency of the abscess to point towards the groin, then 
this situation would be preferable, although I prefer, in even 
these cases, to make a counter opening in the vagina, for 
this precludes the possibility of the abscess sacking or bur- 
rowing further into the tissue. The cavity of the abscess 
should be thoroughly rinsed out with a 2 per cent carbolic 
acid or a 1 to 2,000 corrosive sublimate solution, and if there 
is a tendency in the abscess to close before its cavity is healed 
out, a rubber drainage tube should be inserted, so as to give 
the pus all the possible facility to escape. If the abscess 
breaks into the bladder or into the rectum, then a counter 
opening into the vagina will greatly insure and expedite 
recovery. 

Sometimes the ovaries and tubes become diseased as a 
result of the perimetritic inflammation; this, then, becomes 
a subject of special inquiry and treatment. It should 






284 HOME TREATMENT. 

hardly be necessary to remind the reader that sexual rela- 
tions are to be suspended while there is the least sign of the 
affection to be discerned. Although old adhesions and dis- 
placements, the result of old chronic pelvic peritonitis, are 
often naturally and permanently removed through a super- 
vening pregnancy, the intelligent use of the galvanic cur- 
rent will also accomplish that end. 









CHAPTER XXIV. 

PELVIC CELLULITIS OR PARAMETRITIS. 

The term cellular was given to this tissue, because under 
the microscope it shows large meshes or cell-like cavities, 
that are also termed areola?, hence, the tissue is often called 
areolar tissue ; it is also called connective tissue, because it com- 
bines all the different organs and structures of the body to- 
gether. It is very elastic and contractile, and by the fluid 
which it contains in its areolae, motion of parts on each 
other is facilitated. 

Professor Virchow has applied to it, in the region of the 
womb or pelvis, the term parametric tissue, from the Greek 
prefix para, beside, and the Latin metra, the womb, signify- 
ing the tissue near and around the womb, from which the 
Germans derive parametritis, instead of the English, who 
employ pelvic-cellulitis, each meaning one and the same thing, 
namely, inflammation of the cellular or connective tissue in 
the pelvis or around the womb. 

The female pelvic organs have interspaces between the 
bladder, vagina and uterus in front, and the uterus, vagina 
and rectum behind, also on both sides, between the womb, 
ovaries, and the folds of the broad ligaments, and lastly, be- 
tween these organs and the walls of the pelvic cavity are 
interspaces. These interspaces are filled in or padded out 
by loose cellular tissue. M. Nonat, a celebrated French 
authority, has described this in a beautiful figure, by say- 
ing that "the organs of reproduction float in an atmosphere 
of cellular tissue." This is indeed so, and a consideration 
of an inflammatory condition of this structure, is to con- 
clude the inquiry into the inflammatory diseases peculiar to 
women. 

(285^1 



286 HOME TREATMENT. 

Pelvic cellulitis is one of those diseases for the compre- 
hension of which we are particularly indebted to the re- 
searches of modern pathologists, who have discovered that 
infectious germs are the cause of numerous diseases; pelvic 
cellulitis is one of these, because it originates as a secondary 
result of septic absorption. 

The bacteria or putrefactive germs belong to Protophytes 
— the smallest and simplest of all plants, some of them are 
so small that it requires the highest powers of the micro- 
scope to make them visible. Their growth and multiplica- 
tion have been experimentally demonstrated by artificial 
cultivation, and this now constitutes one of the most in- 
teresting studies of modern pathology. 

Pasteur, Lister, Nsegle and others, regard the decomposi- 
tion in the tissues as a direct result of the vegetation of the 
bacteria. "Decomposition and fungus are inseparable; the 
one ceases when the other is removed. Processes of this 
nature set up by bacteria are best distinguished as fermenta- 
tions." Professor Ziegler, of the University of Tuebingen, 
says: "The healthy organism is always beset with a multi- 
tude of non-infectious bacteria. They occupy the natural 
cavities accessible from without, and especially the alimen- 
tary canal. They feed on the substances lying in their 
neighborhood, whether brought into the body or secreted by 
the tissues. In so doing they set up chemical changes in 
these tissues. While the organs are acting normally, these 
fungi work no mischief to the tissues in which they lie, or to 
the system generally. The products of decomposition set 
up by such non-specific micro-organisms are either harmless 
or are conveyed out of the body before they begin to be 
active. 

"Settlements of this kind may, however, become of im- 
portance, if the bacteria proceed to develop to any unusual 
extent. This happens when the contents of the natural 
cavities in question remains unchanged for any great length 
of time, or when (as in catarrh) the normal secretion under- 



PELVIC CELLULITIS OR PAHA METRITIS. 287 

goes some alteration. The products of bacterial fermenta- 
tion may then accumulate to an excessive amount, and 
products may be found which do not normally occur. 
Highly poisonous substances are formed in many of the 
bacterial decompositions. One of the most speedily fatal 
diseases, septicaemia, is due to blood-poisoning of the sys- 
tem with, the products of bacterial putrefaction, or sepsis. 

"Putrid or septic poison may be absorbed by wounds as 
well as by mucous surfaces. Septicaemia, which has just 
been cited as an instance of septic poisoning, is generally 
due to wound infection. It is due to the absorption of prod- 
ucts of bacterial decomposition formed in a wound con- 
taminated by bacteria. 

"Infectious bacteria have the power of settling, not merely 
in the ingesta and secretions or in dead tissue, but also in 
living tissue. This happens chiefly in the mucous mem- 
brane of the lungs. The uninjured skin is protected against 
invasion by the horny epidermis. Many bacteria can settle 
in perfectly healthy mucous membrane. In the case of 
others we must imagine that they do not find a proper soil 
for their development, unless the mucous membrane is in- 
jured or altered. Of course, injury or alteration of this 
kind may serve to make the outer skin or any other accessi- 
ble tissue, the starting-point of a bacterial invasion (wound 
infection). All that is necessary is that a bacterium should 
reach a spot that affords the conditions for its development. 
If this occurs, it multiplies and forms colonies or swarms. 
These may, according to the species of the fungus and the 
nature of the soil, remain in aggregation, forming heaps 
or masses, or may spread through the tissues. In general 
terms we may say that local settlements of bacteria will 
sooner or later bring about degeneration and necrosis of the 
affected tissue. When this may occur, and how widely it 
may spread, are circumstances depending on the nature of 
the bacteria and of the tissue. 

" The inflammatory processes set up by bacterial action 



288 HOME TREATMENT. 

may be of very different intensity and extent in different 
cases. It may be slight or transient, or may be severe and 
issne in suppuration and an abscess." 

The above quotation is perhaps as concise and complete 
an explanation as the space in this article will permit, and 
if thoughtfully considered, it will be the means of under- 
standing what is to be said of the disease under consideration. 

Pelvic cellulitis is oftener found in childbirth, premature 
labor and abortion, for the reason that it is a wound in 
fection, and the female organism is always more or less 
wounded under these circumstances. In confinement the 
cervix is always more or less torn, and septic matter de- 
posited there often speedily spreads along the lymphatics 
and veins to the pelvic cellular tissue, in fact, the entire 
uterine surface forms a suitable soil for bacterial growth. 
The vagina is also more or less injured or bruised through 
parturient efforts ; this may be in the nature of a laceration 
or an abrasion of its mucous surface. 

Outside of the above causes, the infection may be of 
trumatic origin, the most common causes being operative 
measures on the vagina or womb of a cutting, scraping or 
stitching nature, that were not carried out under strictly 
antiseptic precautions, guaranteeing the exclusion of septic 
germs. Dilation of the cervix with sponge tents or with in- 
struments or probes that were not perfectly cleansed, causes 
infection and a decomposition of the retained secretions, 
which, becoming absorbed, leads to pelvic cellulitis. In sur- 
gical operations and puerperal conditions in which infection 
has been positively excluded, by careful antiseptic measures, 
pelvic cellulitis is impossible. 

The inflammation in this disease is excited by the irrita- 
ting influences of products of septic decomposition; these 
may have been introduced into the system at the time of 
confinement or of an operation, or they may have been in the 
vaginal tract before the operations were commenced. This 
teaches an important lesson, which few seem to have learned; 



PELVIC CELLULITIS OR PARAMETRITIS. 289 

it is this, that the strictest antiseptic regulations in a confine- 
ment or operation are of no avail, if the patient herself is not 
first thoroughly disinfected before the operation begins. 

In the German Empire there is a legal provision giving 
full instructions for the necessary disinfection of the lying-in 
woman and her attendant; if there were such a wise pro- 
vision in this country, we would not hear of so many deaths 
of women in childbed, from blood poisoning. At the Co- 
penhagen International Medical Congress (1884), Professor 
Esmarch, one of the most celebrated of German surgeons, 
said that "humanity demands antiseptic treatment of 
wounds and wounded." I believe that the time will soon 
come that antiseptic regulations in the treatment of diseases 
will not only be compulsory, but that a neglect of the same, 
causing death by blood poisoning, will make the attendant 
liable for exemplary damages. 

Pelvic cellulitis generally develops itself in an acute 
form, and the symptoms are very similar to those of pelvic 
peritonitis, and, like the latter affection, there is always an 
exudation of inflammatory material in these cases, so that 
the meshes of the tissues become soaked like a sponge with 
water. The invasion of the infection is usually signalized 
by a distinct chill or rigors followed by an increased bod- 
ily temperature and a correspondingly rapid pulse. The 
commencement of a parametritis is not often without dis- 
tinct symptoms that affect the nervous system. The patient 
feels uncomfortably depressed, a tired, worn-out feeling over- 
comes her, she loses her appetite, and there is pain in the 
pelvic cavity. This pain is partly due to an accompanying 
peritoneal irritation, or in some cases to a circumscribed in- 
flammation of the peritoneum. Often the pain runs down 
the groin, along the course of the great vessels and nerves; 
this is occasioned from the exudation pressing on the trunks 
of these structures in the pelvis. Pain in the small of the 
back, and painful defecation, with an irritable bladder, are 
due to the same cause. 
19 



290 'HOME TREATMENT. 

Phlegmasia alba dolens, or what was called before the 
dawn of modern pathological science, milk leg, is only an- 
other form or a complication of pelvic cellulitis. This oc- 
curs where the infectious inflammatory process runs along 
the cellular or connective tissue of the large vessels and 
nerves, to the connective tissue of the thighs ; this is a very 
easy matter, because the vessels and nerves are imbedded 
in cellular tissue, and as the vessels leave the pelvis at the 
groin, this tissue is continuous with that of the extremities. 
When the inflammation gets into the thighs, it invades 
either the subcutaneous cellular tissue, that is, the connect- 
ive tissue under the skin, or it runs along the trunks of the 
nerves and vessels; the affected limb becomes then edema- 
tous or swollen, hence the vague term of milk leg, because 
the milk has never anything to do with it. One time it 
was supposed that this affection is only possible after con- 
finement, but this is an error, because phlegmasia alba may 
develop at any time from purulent infection, originating 
from any cause. 

The so-called puerperal or childbed fever is also nothing 
more nor less than an infection of purulent secretion. 

The extent of the exudation varies greatly, both in the 
pelvis and in the limbs. In the pelvis it is sometimes only a 
little swelling on each side of the womb, and between the 
folds of the broad ligaments, small nodules the size of wal- 
nuts can only be felt, while in other cases the entire pelvic 
roof is covered and soaked with the inflammatory effusion. 
The consistence of these swellings or tissues feels at first 
doughy or soft, but after the absorption has been going on 
for a while, it becomes as hard as a board. If the exudation 
begins to suppurate and an abscess forms, then the surround- 
ing tissue becomes soft again, so that the fluctuation of an 
elastic tumor becomes recognizable. 

In the majority of cases the inflammatory process be- 
comes circumscribed in the pelvis, the fever subsides, and 
the pain and sensitiveness in the pelvis disappear. The 



PELVIC CELLULITIS OR PARAMETRITIS. 201 

oxudation has also a circumscribed limit, becoming harder 
and smaller, until it finally has become entirely absorbed. 
In another class of* eases, the swelling remains stationary 
for a long time and a solid tumor remains in the pelvic 
cavity, that may be mistaken for an ovarian or fibroid 
growth, but in the course of a long time, it may gradually 
become absorbed. In a certain proportion of cases the 
course of the disease becomes protracted or chronic, because 
the effusion is very slow to disappear. In these cases there 
is danger of general septic infection or septicaemia, and of a 
spreading of the cellular inflammation to the general peri- 
toneal membrane, which would prove, quite likely, fatal. 
If the inflammation is violent and the infection intense, 
suppuration and abscesses will destroy *the cellular tissue > 
and if the lower extremities become involved, the circu- 
lation in the affected limb may become permanently in- 
jured. The cellular tissue around the veins, or even the 
veins themselves, become more or less affected by the in- 
flammatory process, so that the veins become compressed or 
constricted from the cicatrization around them, or their cal- 
iber may become obliterated from inflammation of the walls 
of the veins, thus offering a permanent impediment to the 
return of the blood to the heart; the affected limb now re- 
mains swollen, and the swelling may entirely subside in the 
recumbent posture at night, but during the day it returns 
again, to make the leg thick and clumsy. 

TREATMENT. 

Prevention in these affections is much better than cure. 
The treatment of a recent case of pelvic cellulitis must be 
energetically antiseptic. The seat of the infection must be 
discovered; the vagina or cavity of the uterus, as the case 
may be, must be thoroughly washed out with a 1 to 2,000 
corrosive sublimate solution. After a thorough disinfec- 
tion, the inflammation and pain can be checked or con- 
troll: 1 by the application of ice bags; this is the remedy 



292 HOME TREATMENT. 

par excellence to check acute inflammatory processes. These 
bags are preferably of rubber, about 4x6 inches in size, and 
when filled with ice and before applied it is more comfort- 
able to the patient to envelop the bag in a thin layer of 
flannel, which takes off the clammy coldness. The patient 
should be kept perfectly quiet and the bowels daily moved 
by a mild purgative. After the sensitiveness and the fever 
have subsided, the absorption of the hardened inflammatory 
remnants is promoted by the daily employment of hot sitz 
baths and the application of tincture of iodine to the ingui- 
nal regions, as well as the use of iodoform suppositories. 

The employment of blistering fluids or plasters is of no 
particular value either to check the inflammation or pro- 
mote the absorption. 

If there are symptoms of suppuration forming abscesses, 
these should be freely opened into the vagina and their cav- 
ities thoroughly rinsed out with a disinfecting solution. 

In the case of phlegmasia dolens alba I have used cold 
water compresses fortified by ice bags with brilliant results, 
but only after all the other treatments that are laid down 
in different treatises had been tried, and failed to give the 
slightest relief. Among these were hot fomentations, large 
repeated doses of morphine, and liniments of everything that 
is usually prescribed to relieve pain ; for the pain in phleg- 
masia is sometimes excruciating. 

My experience of the beneficial effects of ice bags and. 
cold-water compresses in the acute stages of pelvic cellulitis 
and perimetritis, led me to believe that the same measures 
would be useful when the cellulitis was in the cellular tis- 
sue of the extremities, which constitutes phlegmasia dolens, 
ignorantly termed milk leg. This appeared to be heroic 
treatment to the patient, who dreaded the shock and feared 
bad consequences, but she finally consented. 

The following was my method : an ordinary large towel 
was dipped into iced water, wrung out and clapped around 
the affected limb, a heavy flannel roller bandage was then 



PELVIC CELLULITIS or PABAMBTBITI8. 203 

applied from the toes upward to the groin ; flannel is prefer- 
able, because it does not get hard when moist and remains 
softer under similar conditions than cotton material. On 
the most painful parts, like the inner aspects of the thighs, 
the back of the flexure of the knee, or popletial region, and 
the calf of the leg, I laid rubber bags filled with ice in addi- 
tion to the cold-water compresses; these were kept in place 
by a circular binder independent and outside of the roller 
bandage. 

The patient is naturally a little shocked when the cold 
towel is first applied, but the unpleasantness is only mo- 
mentary, and then the reaction brings ease and comfort, so 
that she desires the ice bags to be renewed quite often at 
first, for the patient has now found a remedy that relieves 
the pain as nothing else has ever done before. When the 
towels become dry and hot, the painful symptoms return, so 
that they should be dipped four to six times in the twenty- 
four hours. If the sensitiveness on pressure and other in- 
dications denote that the acute inflammatory process is 
checked, then the compresses and ice may be discontinued. 
This treatment avoids suppuration and the formation of ab- 
scesses, while hot applications encourage them. 

A mild stimulating diet of milk and egg punch with ten 
to fifteen grains of quinine each day should be given in all 
infectious inflammations. 



CHAPTER XXV. 

ELECTRICITY AS A REMEDY. 

In a brief reference to the medical virtues of electricity 
in the treatment of diseases of women, only an outline of 
its physics can be given, so as to give the reader an approx- 
imate idea of its origin and phenomena. 

The use that is being made of electricity in the arts has 
convinced everybody that it is a most powerful agent, which 
manifests itself in so many different phenomena that it is as 
mysterious to-day as it was centuries before Christ, when 
the Greeks first observed it in amber when rubbed with 
silk, and from which the term has been derived. 

Electricity is developed in bodies from a variety of 
causes, among which are friction, pressure, chemical action, 
heat, and magnetism. We are acquainted with it only 
through the peculiarity of its action, and it behaves as a sub- 
tile, imponderable fluid of a compound nature, possessing 
opposite polarity when excited, giving rise to positive and 
negative electricities, but when at rest these forces seem to 
neutralize each other, and as such pervade all matter. 

Chemical action is usually the most convenient for ob- 
taining electricity for medicinal purposes, and the arrange- 
ment through which this is accomplished is called a cell or 
battery. 

A battery in its simplest construction is made of a plate 
of zinc and a plate of copper partially immersed in dilute 
sulphuric acid. A disturbance of the neutral electricity 
now ensues, and by means of a delicate instrument, it may 
be observed that the zinc plate possesses a feeble charge of 
negative and the copper a feeble charge of positive electric- 
ity; at the same time there is a slight escape of hydrogen 

(294) 



PLATE V. 



^x^/^-^' 




Apostoli's method of employing intense galvanic currents 
without discomfort or injury to the patient. 

The internal electrode, which he calls the excitateur intrauterine is held in the hand 
of the operator. The dispersing electrode covers the abdomen. 



ELECTRICITY AS A REMEDY 295 

from the surface of the zinc. If now the plates are con- 
nected by means of a metallic wire, the chemical action in- 
creases and the hydrogen gas is now discharged from the 
surface of the copper. The wire is now traversed by an 
electric or voltaic current, which imparts to the connecting 
wire, thermal, magnetic and other properties. 

The electricity does not, however, correspond to that 
which was peculiar to the metallic plates before they were 
connected by the wire, but the opposite electrical conditions 
discharge themselves from the wire: the direction of the 
current in the fluid, being from the positive or copper plate 
to the zinc or negative plate, and vice versa, so that the wire 
of the zinc plate is now positive, while that of the copper is 
negative. 

Poles and electrodes. The wires or terminals are called 
the poles of the battery ; instead of the term poles, the word 
electrode is now generally used. From what was said of the 
origin and direction of the current in the fluid, it is impor- 
tant to remember that the positive electrode or wire is con- 
nected to the negative plate, while the negative electrode is 
connected with the positive plate. 

According to the extent of surface of both zinc and cop- 
per plates, exposed to the chemical action of the diluted sul- 
phuric acid, or to the number of cells that are employed, by 
connecting the copper plate of one cell to the zinc plate of 
the next, the force and quantity of the electric current is 
correspondingly increased. 

Batteries which consist of one solution and two metals 
rapidly lose their intensity, partly from the decrease in the 
chemical action owing to the neutralization of the sulphuric 
acid by its combination with the zinc, and partly from sec- 
ondary currents, depositing a layer of hydrogen and metallic 
zinc on the copper plate, which destroys the dissimilarity 
of the metals, so that the electrical action ceases or the 
plates become polarized. 

For this reason these single fluid batteries have almost 



296 HOME TREATMENT. 

entirely gone ont of use, and batteries with two liquids have 
taken their place. 

Electrolysis means to dissolve or decompose, by means 
of electricity, an organic or inorganic substance into its 
original elements. If, for instance, a current of electricity 
of four or five Bunsen's cells is conducted to two inverted 
glass tubes, filled with water slightly acidulated to increase 
its conductivity, gas bubbles rise from the surface of each 
pole, and upon examination it is found that hydrogen is 
liberated at the negative pole and oxygen at the positive 
pole; and as the volume of hydrogen liberated is about 
twice that of oxygen, the experiment gives at once the qual- 
itative and quantitative analysis of water. 

Professor Bartholow, in his treatise on Medical Electricity 
says: "As animal tissues are composed of substances amen- 
able to electrolytic decomposition, it is obvious that they 
must yield up their component elements in accordance with 
the laws of electrolysis. Albumen is coagulated, salts are 
separated into acids and bases, and water is resolved into 
oxygen and hydrogen. When the salts contained in the 
animal tissues — soda, potassa, lime — and water, are decom- 
posed, the acids and oxygen appear at the positive pole, 
and the alkalies and hydrogen at the negative. It follows 
that if the positive electrode be composed of metal, it will 
be corroded by the action of chlorine and the acids, and the 
negative will remain unacted on and smooth. The tissues 
in the vicinity of each electrode are necessarily affected by 
the elements brought to them in accordance with chemical 
laws. About the positive the mineral acids and chlorine 
form combinations, and hence do not attack the tissues with 
the same energy as those about the negative pole. If, how- 
ever, the positive electrode is composed of zinc, for example, 
the chlorine attacking it will form chloride of zinc, a very 
corrosive material. This principle has been utilized to pro- 
duce caustic effects at the positive pole. Although the neg- 
ative electrode remains smooth, much more than at the pos- 



ELECTRICITY AS A REMEDY. 207 

itive arc seen these destructive effects from the action of the 
free alkali liberated in its neighborhood. When an ordi- 
nary electrode of carbon covered with soft sponge is made 
to conduct a strong galvanic current, the skin speedily be- 
comes reddened, and may be made to ulcerate if the contact 
is sufficiently prolonged. If the carbon is applied directly, 
an intense burning is produced and the tissues are destroyed, 
leaving a slough, which is slowly detached and the ulcer re- 
maining is difficult to heal. The caustic action is due 
chiefly to the soda, potash, and lime. Some effect must also 
be allowed to the disassociation of the tissues, to their trans- 
ference from point to point and at the negative pole to the 
mechanical action of the liberated hydrogen." 

Interpolar regions. The reader must have been im- 
pressed with the peculiarity of each pole in possessing affin- 
ity or attraction for certain elements that constitute the 
animal tissue. Oxygen and acids accumulate around the 
positive pole, while alkalies are attracted to the negative 
pole ; thus it must be an absolute fact that an actual trans- 
fer of particles in both directions to each pole must traverse 
the tissue lying between the two poles ; this accounts in a 
great measure for the difference of the local effect on the 
tissues around the poles, one being in the nature of an acid 
the other of a caustic alkali. This naturally gave rise to an 
inquiry as to the effect that the galvanic current has on the 
structure between the two poles. 

Dr. G. Betton Massey, author of " Electricity in the Dis- 
eases of Women," asks and answers this question in the fol- 
lowing manner: " What can be therapeutically accomplished 
when the seat of the disease is necessarily situated beyond 
the direct reach of the electrode ? An answer drawn from 
both neurological and gynecological experience is that much 
can be accomplished ; and this is doubtless due, in the first 
place, to the influence upon nutrition of the chemical 
changes that occur throughout the circuit, in the onward 
progress of the particles that appear free finally at the poles 



298 HOME TREATMENT. 

to the influence upon nutrition of the circulatory changes 
that result from vasomotor stimulation, and to the contrac- 
tions produced in unstriated muscular tissue by heavy cur- 
rents even at a distance. These results of quiet current 
transmission are governed in magnitude at a given spot 
by the density of the current at the situation and by the du- 
ration of the application. To accomplish much in the more 
distant parts of this region considerable strength must be 
employed, hence a delicate judgment is demanded in the se- 
lection of the size of the active pole to avoid cauterization 
on the one hand, and too great a diffusion on the other." 

To within a comparatively recent period, the methods 
of applying the electric current for the removal of abnormal 
growths have been somewhat crude if not dangerous. It 
appears that formerly altogether too much stress or weight 
was laid on the chemical or electrolytic effects that the elec- 
trodes wrought in the tissues, and very little or no credit 
was given to the passive current of galvanism as it traversed 
the tissues from pole to pole. Dr. Ephraim Cutter, of New 
York, advocated the so-called electro-puncture, and in the 
galvanic treatment of fibroid tumors of the uterus, these 
punctures were made through the abdominal walls. The 
electrodes for this purpose were stiletto shaped, with blades 
five inches long and three-eighths of an inch at their widest 
part; these were inserted into the tumor from opposite points. 
Wounds that were thus inflicted, necessarily involved more 
or less danger, and, although Dr. Cutter reported a great 
number of cures, the percentage of mishaps was too great to 
make electrical treatment popular among the profession. 

It was not until Apostoli, a French physician, greatly 
modified the methods of employing electricity in the treat- 
ment of fibroid tumors, and sheared it in a great measure, 
not only of its dangers, but also of pain, that the medical 
profession took the question of electrical treatment in real 
earnest. The practice of Apostoli and his results were pub- 
lished in a monograph by Carlet, entitled, Du traitement 



ELECTRICITY AS A REMEDY. 299 

electrique des tumewrs fibreuses de ruterus, Paris, lS8/f. Apos- 
toli evidently started out with a view to modify the mosl 
objectionable features of the electrical treatment. This con- 
sisted in reducing the number and size of the punctures 
and to lessen the painful sensation of the electric current to 
its minimum, so that the main points of difference are the 
shape and size of electrodes, and the site that is chosen for 
the puncture. In the first place he uses only one piercing 
or needle electrode, which is much smaller than that of 
Cutter, this may be attached to either the positive or nega- 
tive cord of the battery, according to the accompanying 
symptoms. When hemorrhage is a symptom, the positive 
pole is used internally or carries the needle on account of 
its anti-hemorrhagic property, otherwise the negative pole 
carries the piercing electrode. This electrode is always 
used internally to puncture through the vagina or through 
the cervical tissue into the tumor; this is not nearly so 
painful as piercing the abdominal walls, nor does it wound 
the peritoneum. 

The other electrode is called the dispersing electrode, be- 
cause its purpose is to so disperse or scatter the current of 
this pole that it is hardly felt by the patient, much less 
produces any electrolytic or chemical effect on the skin. 
This electrode is made from a sheet of lead or copper nine 
by ten inches and covered with a layer of wet absorbent cot- 
ton; it is applied over the abdomen. This method is much 
safer than that formerly advocated by Dr. Cutter, and the 
results are much better. Dr. Engelman, who has accepted 
this method, says: " In electrolysis an intensity of 50 to 250 
milliamperes may be used for from three to eight minutes. 
All possible precautions must be taken in the first sitting in 
order to discover any idiosyncrasy of the patient, and a cur- 
rent of 50 milliamperes will suffice, attained by slow in- 
crease. The patient should lie down quietly for several 
hours after the application. If an intensity as high as 100 
milliamperes is used at the first sitting, it is preferable that 



300 HOME TREATMENT. 

she remain in bed for the first twenty-four hours, and that a 
cold compress or an ice bag be placed upon the abdomen, 
to overcome any tendency to inflammatory reaction which 
may occur ; hence the attention to details which is necessary, 
and the precautions desirable in a first puncture, until the 
sufferance of the individual patient is tested. The applica- 
tion is repeated, according to the demands of the case and 
the severity of the treatment, once or twice a week." 

The milliampere meter is a galvanometer to measure the 
quantity of electricity that is applied, and as a chemical bat- 
tery will of necessity change, a meter is the only means of 
judging the intensity of the current ; so that without one 
there is danger of applying the current too strong, or an in- 
justice may be done to the patient, and reproach cast on the 
treatment by not using it strong enough. 

At the annual meeting of the American Medical Associ- 
ation, at Chicago, in 1887, Dr. Martin read a paper, in which 
he reported three cases that were treated with the most satis- 
factory results without puncture. The positive or external 
electrode was applied over the abdomen after the manner of 
Apostoli, and the negative electrode was placed in the rec- 
tum, vagina or uterus, in such a way as to cause the cur- 
rent to traverse the largest diameter of the tumor; this 
method is to my mind the ideal of an electrical treatment, 
it is galvanism without corrosion or electrolysis. 

The number of eminent authorities that I have quoted, 
can hardly fail to convince the reader that electrical thera- 
peutics in the treatment of fibroid tumors are not only effi- 
cacious, but in the infancy of experimental growth, so that 
every day will add new proofs and improved methods to the 
history of this most interesting subject. But this treatment 
is not limited in its usefulness to the removal of abnormal 
growths, for it has proven itself equally as effectual in the 
treatment of chronic inflammatory conditions of the pelvic 
organs. I have myself attained great success in curing 
certain forms of these diseases since the publication of 



ELECTRICITY AS A REMEDY. 301 

"A New Treatment of Chronic Metritis," by the same inde- 
fatigable author, Georges Apostoli, of Paris. 

The value of electricity is now so firmly established that 
a physician who, ignorant of its virtues, and laboring under 
this self-imposed ignorance, brushes aside any reference to 
or desire for electrical treatment with a supercilious air, 
claiming " that there is nothing in it," advertises himself as 
incompetent or insincere. 

It must be apparent to anyone who has followed this 
brief outline from the beginning, that this subject requires 
a special and individual devotion, so as to become familiar 
not only with the elementary principles of the physics of 
electricity, but with the technique of applying the treatment 
in each individual case. This, few persons have the honesty 
or ambition to acquire, and if they own a battery, it is more 
for show than for use. I am convinced that there are great 
possibilities in store for the curative value of the galvanic 
current, but it also requires a high order of intelligence to 
employ it, in order that those hopes may be realized. 

"The positive pole is anodyne, sedative, anti-congestive, 
and anti-hemorrhagic. It combats and prevents the ten- 
dency to excessive vascularization, and consequently relieves 
congestion and inflammation and the pain depending upon 
these conditions. Its local or polar action, when used within 
the uterus, is hemostatic or styptic, and caustic, with high 
intensities of current. 

" The negative pole is stimulating and has a marked electro- 
lytic action. It tends to produce congestion, and a deriva- 
tive effect which favors absorption of tumors, inflammatory 
deposits and adhesions. But great care must be observed in 
using it in some conditions, lest a new inflammation be re- 
kindled." 

I have the record of a case where the womb was re- 
troflexed and tied down by old inflammatory adhesions for 
nine years; the retroflexion dated back to a miscarriage. 
This woman had been aninvalid since that time; her appe- 



302 HOME TREATMENT. 

tite was poor, and her digestion poorer, she was excessively 
constipated, suffered from pain during menstruation, but at 
other times there was a constant pain in the small of her 
back, which ran down the right thigh, the bladder was irri- 
table, and there were neuralgic pains shooting from the 
ovaries down the groins. All these symptoms became more 
or less aggravated every few weeks or months. The womb 
was so firmly fixed or glued down on the lower portion of 
the spine, that it could not be moved an iota. This woman 
had tried all the remedies that I could suggest, except gal- 
vanism. This I concluded to try, by placing a large dis- 
persing electrode on the small of her back, and the other 
electrode, properly prepared, so that it did not burn or cau- 
terize, was introduced into the vagina, against the posterior 
aspect of the uterus. A current strength of from 90 to 
120 milliamperes was applied every other day for ten min- 
utes; in six weeks the organ was quite movable, and in five 
months all adhesions had melted away, and the womb occu- 
pied its normal position, and the patient was in every way 
restored to health. 

The diseases that are curable by galvanism are the differ- 
ent forms of subacute or chronic inflammation of the ovaries, 
and the consequent enlargement of these organs, small cysts 
or fibro-cysts of the ovaries are also amenable to the gal- 
vanic puncture. 

Catarrhal inflammation of the Fallopian tubes, or when 
either or both ends are agglutinated with inflammatory exu- 
dation, so as to pen up their contents, which may be mucous, 
water, pus or blood, these fluids should be first aspirated or 
drawn off, and then, by means of appropriate galvanism, the 
normal conditions of the tubes may be restored. 

Chronic catarrhs of the womb are especially suited for 
galvanic treatment, and when the inflammation invades the 
muscular structure of the uterus, giving rise to what was 
described as chronic metritis, there is no remedy that will 
yield the same positive and satisfactory result as electricity. 



ELECTRICITY AS A REMEDY. 303 

Plate V gives a practical illustration of the employment 
of electricity for chronic inflammation of the uterus; the in- 
ternal or negative pole is introduced into the uterine cavity 
and held there by the operator, the external or dispersing 
pole spreads over and rests on the abdomen. 

Sub-involution of the uterus. I have already referred 
to this affection as an arrested involution of the womb after 
confinement at the end of the natural term, and after abor- 
tion. The womb in this condition remains permanently and 
preternaturally enlarged, and its entire tissue becomes the 
seat of a subacute or chronic inflammatory process. The 
vagina is also more or less relaxed, so that the heavy uterus 
sinks down into the pelvis, imparting to the patient a drag- 
ging or bearing-down sensation, which makes walking or 
any other exertion exceedingly difficult. In subinvolution 
an extra uterine electrode is not required, but only a vaginal 
electrode, so employed that a current of high intensity is 
passed through the uterus ; this varies from 50 to 150 milli- 
amperes. The duration of each galvanization is from eight 
to ten minutes, and should be repeated every third or sixth 
day. I succeed as a rule in six to eight weeks in restoring 
the organ to its normal size, which I ascertain through com- 
parative measurement at the beginning and end of the 
treatment. 

If the subinvolution is complicated with retroflexion, then 
intra-uterine galvanization after the organ is replaced is 
the most effective treatment. Old pelvic adhesions and ex- 
udations as a result of pelvic cellulitis or peritonitis are 
amenable to galvanization after hot douches, sitz baths, and 
other discussives have failed to excite absorption. 

Hemorrhoids and prolapse of the rectum ; the former is 
a frequent concomitant of constipation, and the latter may 
be the result of an imperfect involution after confinement. 
I have employed galvanism for either with the most bril- 
liant results. 

It would be interesting for the reader were I to continue 



304 HOME TREATMENT. ___ 

to cite different diseases in which electricity has been suc- 
cessfully employed, but that would require a systematic 
arrangement of the subject, which would be incompatible 
with the original purpose of this book. I simply desire to 
awaken an interest in a comparatively new remedial agent, 
in its present field of employment. There may be a great 
many ways to get relief, but that course which offers the 
least risk to life and the least suffering to the living is the 
one that should recommend itself to the sufferer. What 
patients need is not brilliant surgical exploits to make the 
reputation of an ambitious operator, but the conscientious 
aid of the conservative physician who is content to labor in 
the less pretentious capacity of an assistant to nature's cura- 
tive energy. 



CHAPTER XXVI. 

SIGNS AND SYMPTOMS OF PREGNANCY. 

Pregnancy is the condition in which the female has 
within her an impregnated, fecundated germ, which gradually 
becomes developed in or out of the womb. In a perfectly 
normal state of things, the impregnated ovum becomes 
attached to the inner surface of the womb by virtue of a 
preordained vital force by which the ovum becomes animated 
at the moment of conception. It obtains its nutrition from 
a plexus of blood vessels, by means of which the ovum is 
attached to the inner side of the walls of the uterus, and 
this complex of vessels grows with the development of the 
fetus, and constitutes the placenta, which, together with the 
membranes and the umbilical cord, is called the afterbirth. 

The growth of the embryo, which is the predestined 
child in the mother's womb, occupies a period of ten lunar 
months, or two hundred and eighty days — this is the aver- 
age term of pregnancy, although the duration of pregnancy 
is prolonged in a large proportion of cases to three hundred 
days, and even longer, while in a small proportion of preg- 
nant women the period of gestation falls naturally shorter 
than two hundred and eighty days. 

In a small number of pregnancies the impregnated ovum 
is arrested at the ovary, or on its passage from the latter 
through the Fallopian tubes; it then does not arrive in the 
cavity of the uterus. This state of things is unnatural, 
hence termed preternatural, because the growth of the fetus 
takes place out of the uterus, and this is also called extrauter- 
ine pregnancy, which may take place in the ovary, Fallopian 
20 ( 305 ) 



306 HOME TREATMENT. 

tubes, or cavity of the abdomen. False pregnancy implies 
that there was no pregnancy at all, or in other words, that 
there was no fetus, and that the enlargement was due to 
something else. 

In pregnancy the female experiences signs and symp- 
toms resulting from changes in the condition of her organs 
and functions. The suppression of the courses or menstrual 
discharges is considered in the popular mind an unerring 
proof of pregnancy, yet, as a matter of fact, this is far from 
the truth. I have known of two women who menstruated 
regularly during the entire period of their pregnancies, and 
there are a number of reliable cases recorded of women who 
menstruated during pregnancy and at no other time. 

It is a rule, that the menses cease during pregnancy, but 
it is equally certain that the menstrual function becomes 
suspended from other causes, and these are quite numerous, 
so that taken by itself, the sign is of little importance. 
Young married women not infrequently have a slight men- 
struation for two or three periods after their first conception, 
and on the other hand, newly married women will have their 
menses occasionally arrested, and this may continue for two 
or three months and indeed no pregnancy exist. 

Nausea and vomiting is also presumptive evidence of 
gestation. Some women are affected with sick stomach 
almost from the moment of conception, and from actual 
experience they are so certain of their condition, that they 
can calculate with certainty the day of their confinement 
from the time when they had their first feeling of nausea. 
Experience seems to teach that a certain amount of nausea, 
the morning sickness, and the vomiting which accompanies or 
follows it, is to be met in women who go through a natural 
or healthy pregnancy, so that many eminent authorities 
have looked upon this symptom as a physiological accompa- 
niment, and one of the most constant and reliable symptoms. 
The vomiting and nausea of pregnancy is different from that 
which is an indication of general ill health ; in pregnancy 



SIGNS AND symptoms OF PEEONANCY. •'> ,l < 

tlio vomiting is followed with a sense of relief, and the 
patient is for the time being quite easy. The length of time 
that women feel this gastric irritability varies in different 
individuals; ordinarily it will cease about the fourth month, 
sometimes sooner, and it may return again during the last 
two or three months of gestation. It is supposed to be due 
to a reflex action of the spinal cord from the uterus to the 
stomach. It must be remembered, however, that a disease 
of the uterus, a fibroid or ovarian tumor, and a suppression 
of the menses from other causes than pregnancy will occasion 
nausea and vomiting. 

A capricious appetite is another of the peculiarities of 
pregnancy, a longing for unnatural food, so that some 
women will enjoy eating such things as chalk, slate pencils, and 
similar indigestible stuff; this I have always considered a form 
of hysteria, that is, a functional derangement of the nervous 
system, for wdiich I gave ten grains of bromide of sodium 
three times a day, with the best results; others again became 
passionately fond of sour salads, or strong condiments like 
mustard, Worcestershire sauce, and salt fish, while others 
again long for fruits. 

Salivation of the mouth is another very unpleasant 
symptom w T hich annoys some women when they are preg- 
nant, for they will secrete such enormous quantities of saliva, 
that they cannot help drooling from the mouth when they 
speak. In salivation of pregnancy the gums do not become 
sore as in the salivation from mercury; in the former the 
irritation is confined to the salivary glands alone. The 
wonderful sympathy that exists between remotely situated 
organs of the body is here strikingly illustrated between the 
sexual organs and the salivary glands in both sexes. In 
mumps also, which is an inflammation of the salivary gland, 
it is not unusual for the testes in the male and the mammae 
in the female to become swollen and painful, and as soon as 
this swelling takes place, the inflammation of the salivary 
gland disappears. 



308 HOME TREATMENT. 

The breasts become enlarged and otherwise altered in 
pregnancy, the enlargement is accompanied with more or 
less sharply shooting pain, they also become harder and are 
more movable than otherwise. The nipple becomes more 
prominent and painfully sensitive, the veins that run from 
the breast become distended so that they can be readily 
traced by the eye. The presence of milk in the mammse is- 
another sign, but that, too, is only presumptive, because the 
secretion of milk takes place in other conditions than that 
of pregnancy; even the newly-born infant has sometimes 
milk in its breasts, and milk has been recognized in the 
breasts of some males and not infrequently in those of young 
virgins. 

Pigmentation or the deposit of coloring matter in preg- 
nancy has long been observed as a prominent symptom and 
when taken together with other signs it is worthy of careful 
consideration, but here, too, we encounter the obstacle to any- 
thing of a positive nature, for discoloration is also met with 
in females who are suffering from pelvic diseases and who 
are not pregnant. Areola is the technical name of that 
peculiar circle which immediately surrounds- the nipple. 
In a healthy virgin this circle is characterized by a beautiful 
rose-tinted blush, but under the influence of disease, even in 
the virgin the circle becomes more or less discolored. When 
pregnancy has occurred the areola around the nipple becomes 
darker and darker; other parts of the body become similarly 
discolored, this occurs on the abdomen and perineum. 

The womb descends during the first two months of preg- 
nancy, this constitutes a kind of physiological falling of the 
womb and indeed the accompanying symptoms of a preg- 
nant woman are often similar or identical to that diseased 
and permanent condition of physical suffering, namely, fall- 
ing of the womb. Perhaps the most common symptoms of 
the descent of the uterus will be more or less frequent desire 
to pass water, because of the dragging of the womb on the 
neck of the bladder; sometimes there is also a straining or 



SIGNS AND SYMPTOMS OF PREGNANCY. 309 

inclination to go to stool, owing to pressure on the rectum 
from the same cause. 

The umbilicus or navel becomes painful and even de- 
pressed from traction of the superior ligament of the bladder, 
which is attached to the umbilicus, thus illustrating the 
operation of 'cause and effect, namely, as the bladder is de- 
pressed by the descended uterus, the bladder in turn pulls 
on the umbilicus to which its ligament is attached. The 
pregnant uterus remains only the first few months in this 
depressed state; at the third month, as a result of its continual 
growth and that of the fetus, the uterus ascends out of the 
pelvis and as a natural consequence the symptoms of the 
bladder and rectum subside. Towards the end of the ninth 
month the womb again descends into the pelvis and with 
this there may be a return of the irritation of the bladder 
and a feeling of bearing down or tenesmus of the rectum. 
The descent of the uterus toward the close of pregnancy 
diminishes the prominence of the abdomen, and as the 
diaphragm has freer play, the respiration becomes easier; if 
there was any cough that, too, disappears, and on the whole 
the woman feels herself more comfortable and in happy 
spirits. This may even arouse suspicion in her own mind 
as to her condition, because she does not know the cause of 
the change; it may portend to her that something is not 
right, that she is not pregnant or that her child may be 
dead. In women who have borne one or more children in 
a natural manner, the descent of the womb is of no particu- 
lar moment in the last months of gestation, because the 
abdominal walls having been stretched by previous preg- 
nancies the body or fundus of the womb may fall forward 
and give the lungs and other organs relief from pressure, 
nut in the first pregnancy this is never the case, because the 
abdominal walls are too tense to allow this normal ante- 
version. 

The German school of midwifery has laid down an im- 
portant rule as a consequence of this observation, and I have 



310 HOME TREATMENT. 

never known an exception to occur in my experience. The 
rule is that when the uterus does not descend into the pelvis 
toward the close of the first pregnancy, it is because there is 
a disproportion between the child's head and the maternal 
pelvis, or in other words that either the child's head is too- 
large for a natural or unaided delivery to take place, or that 
the pelvis of the mother is too small for a natural delivery 
to take place, and this is true, and knowing this to be true 
at the outset or commencement of a confinement it would 
be only torture and a valuable loss of time to wait at the 
bedside of a woman suffering with the pangs of childbirth 
in the vain hope that she might deliver herself — when in 
truth and as a fact that cannot be done without the aid of 
scientific assistance. 

The vagina and external organs are more or less modi- 
fied in pregnancy. The vagina becomes wider and shorter 
and as there is an increase of spongy tissue, it presents a 
swollen appearance. The mucous glands become larger and 
secrete a greater abundance of mucus. The internal surface 
of the vagina becomes discolored in consequence of preg- 
nancy and I believe that it is one of the most reliable pre- 
sumptive signs; the mucous membrane presents a sort of 
bluish tint, a French authority calls it a violet hue, not 
unlike the lees of wine. 

Quickening is a term that is employed to designate the 
particular length of time that pregnancy has existed, and at 
the same time to furnish evidence to the mother through the 
movements of the fetus that she carries within her womb a 
living being. In a former chapter I have already detailed 
the theory of the ancients upon this subject, which was as 
absurd as it was fanciful. The late Professor Bedford defines 
"quickening as nothing more than the ordinary result of 
progressive increase when the physical organization of the 
fetus has reached a state of development which imbues it 
with the power of movement — a movement dependent upon 
muscular contraction." The period of quickening is usually 



SIGNS AND SYMPTOMS OF PREGNANCY. 311 

about the fourth and a half month or the middle term of 
pregnancy. 

Pulsation of the fetal heart, when heard, is no longer 
presumptive but absolutely positive evidence that pregnancy 
exists. That the heart of the child can be distinctly heard 
to beat in its mother's womb was one of the greatest discov- 
eries in midwifery. The pulsations of the fetal heart are 
much faster than those of the mother's heart, hence there is 
no danger of getting them mixed; while the child's heart 
averages from one hundred and ten to one hundred and 
sixty per minute, the heart of the mother averages from 
seventy-five to eighty beats. There are cases where the 
mystery of a pregnancy can be solved beyond a possibility 
of a doubt, through the recognition of the pulsations of the 
fetal heart, and yet a woman may be pregnant in whom it 
will be impossible to distinguish the action of the child's 
heart, at the termination of her period of gestation she will 
bring forth a healthy child. 

The question whether a female is pregnant will, from the 
very nature of the symptoms always remain debatable in a 
certain proportion of cases, or, in other words, there is no 
sign or symptom that is reliable and if reliable it is not uni- 
formly present. From a medico-legal standpoint the ques- 
tion will always be of great importance, as it frequently 
involves the guilt or innocence of the accused; the social 
standing of one, or the merited punishment of the other, and 
it does seem like a travesty on both science and justice that 
at certain stages and in certain conditions no signs or symp- 
toms are absolutely reliable. The unfortunate creatures 
whose illness may imitate or simulate the symptoms of preg- 
nancy must always receive the benefit of the doubt, this 
would avoid the possibility of wrecking innocent lives. Pro- 
fessor Bedford reports a case in his work on obstetrics which 
is as sad as it is instructive, he says: "I was requested to 
visit a lady who was residing in the State of New Jersey, 
about thirty miles distant from New York. On my arrival 



312 HOME TREATMENT. 

I was received by her father, a venerable and accomplished 
gentleman. He seemed broken in spirit, and it was evident 
that grief had taken a deep hold of his frame. On being 
introduced into his daughter's room, my sympathies were at 
once awakened in beholding the wreck of beauty which was 
presented to my view. My presence did not seem to occasion 
the slightest disturbance; she greeted me with these words: 
'Well, doctor. I am glad to see you on my beloved father's 
account, for he will not believe that I cannot yet be restored 
to health. Life, however, has lost all its charms for me, and 
I impatiently long for the repose of the grave.' These words 
were spoken with extraordinary gentleness, but yet with an 
emphasis which at once gave me an insight into the character 
of this lovely woman. 

"Her father was a clergyman of high standing in the 
English Church, and had a pastoral charge in England, in 
which he continued until circumstances rendered it neces- 
sary for him to leave that country, and seek a residence in 
America. At a very early age, this young lady had lost her 
mother, and had almost been entirely educated by her 
father, whose talents, attainments, and moral excellence ad- 
mirably fitted him for this important duty. When she had 
attained her eighteenth year, an attachment was formed be- 
tween her and a young barrister of great promise and respec- 
tability. This attachment soon resulted in a matrimonial 
engagement. Shortly after the engagement she began un- 
accountably to decline in health; there was a manifest change 
in her habits ; she was no longer fond of society ; its pleas- 
ures ceased to allure and prove attractive; the friends whom 
she had caressed with all the warmth of a sister's love, now 
became objects of indifference; in a word she was a changed 
being — her personal appearance exhibited alterations evident 
to the most superficial observer; her abdomen enlarged, the 
breasts fuller than usual, the face pale and careworn, and 
the appetite capricious, with much gastric derangement. 
Many were the efforts made to account for this change in 



SIGNS AND SYMPTOMS OF PREGNANCY. 313 

the conduct and appearance of the young lady in question. 
Speculation was at work, and numerous were the surmises 
of her friends. The rumor soon spread that she was the 
victim of seduction, and her altered appearance the result of 
pregnancy. 

"The barrister to whom she was affianced heard of these 
reports, and instead of being the first to stand forth as her 
protector, and draw nearer to his heart this lovely and injured 
girl thus measurably assuaging the intensity of grief with 
which she was overwhelmed, addressed a letter to her father 
requesting to be released from his engagement. This was, 
of course, assented to without hesitation. The daughter, 
conscious of her own innocence, knowing better than any- 
one else, her own immaculate character, and relying on 
heaven to guide her in this her hour of tribulation, requested 
that a physician should be sent for, in order that the nature 
of her case might be clearly ascertained. A medical man 
visited her, and after an investigation of her symptoms, in- 
formed the father that she was undoubtedly pregnant, and 
suggested that means should be taken to keep the unpleas- 
ant matter secret. The father, indignant at this cruel im- 
putation against the honor of his child, requested an 
additional consultation. This resulted (as usual) in a con- 
firmation of the opinion previously expressed, and the feel- 
ings of that parent can be better appreciated than portrayed. 

"That good man resigned his pastoral living to proceed 
with his daughter to America. On her passage to this 
country, the daughter became extremely ill, and the advice 
of the physician on board the vessel was requested; he too 
told the father that there was danger of premature delivery, 
for he simply took appearances as his guide, and at once 
concluded that she was pregnant. 

"This is about the substance of what I learned of this 
interesting and extraordinary woman. I proceeded with 
great caution in the investigation of her case, and after a 
faithful and critical survey, most minutely made in reference 
to every point, I stated in broad and unequivocal language 



314 HOME TREATMENT. 

that she was not pregnant. The only reply the gentle crea- 
ture made on hearing my opinion, was — ' Doctor, you are 
right.' The father was soon made acquainted with the re- 
sult of my examination, but he indicated not the slightest 
emotion. He asked me whether something could not be done 
to restore her to health, and I thought that the old man's 
heart would break when I told him that his daughter was 
in the last stages of consumption. 

"It was the misfortune of this young lady to labor under 
an affection of the womb, which simulated, in several im- 
portant particulars, the condition of pregnancy, and which 
the world in its ignorance and undying thirst for scandal,, 
might have readily supposed did in fact exist ; yet, there 
was no excuse for the physician, guided as he should have 
been by the lights of science, and governed by the principles 
of sound morality. The result of my investigation impressed 
me with the conviction beyond any shade of doubt, that 
the entire train of symptoms indicating pregnancy was due 
to the presence of a large fibrous tumor occupying the 
cavity of the uterus. About four weeks from this time I 
received a note announcing her death and asking that I 
would hasten to the house for the purpose of an examina- 
tion. Dr. Ostrom, now practicing in Goshen, assisted me in 
the autopsy. As the father stood before me he was not un- 
like the stricken oak in the forest, which, though stripped 
of its branches, was yet upright and majestic. The moment 
I removed the tumor from the womb he seized it convul- 
sively, and exclaimed, 'This is my trophy; I will return 
with it to England, and it shall confound the traducers of 
my child!' 

"Here, you perceive, both character and life were sacri- 
ficed by error of judgment on the part of those whose coun- 
sel had been invoked. Without a due responsibility, heed- 
less of the distressing consequences, the medical gentlemen 
rashly pronounced an opinion which consigned to an early 
grave a pure and lovely being, and broke the very heart 
strings of a devoted and confiding parent." 



CHAPTER XXVII. 

PRECAUTIONS AND SUGGESTIONS TO PREGNANT 

WOMEN. 

There is a hygiene of pregnancy which the enceinte fe- 
male should observe, for by so doing, she will not only 
make the period of her gestation less onerous to herself, but 
she will be able to materially contribute toward the accom- 
plishment of a natural childbirth. Although pregnancy is 
a physiological process, the conditions in the female econ- 
omy, under which this is carried on, are at variance with 
those which are to be found in the unimpregnated state, and 
as a consequence it rationally follows that the pregnant 
female should endeavor to conform to the demands which 
the altered relations require. 

If the pregnant woman is properly clothed to begin with, 
she will greatly mitigate some of the symptoms which very 
often mar her well-being. The clothing should neither be 
too heavy in summer, nor too light in winter, she must dress 
so as to conform to the season and feel comfortable; but by 
all means the chest and abdomen should be kept free from 
pressure, the skirts must be supported from the shoulders, 
and the corset also, should be dispensed with, and a waist 
worn instead, one that partly answers the purpose of a cor- 
set, and to which the skirts can be fastened or buttoned at 
the same time. I have no respect nor patience for those 
women who desire to conceal by tight lacing, the appearance 
of their pregnancy. Motherhood, whether active or pros- 
pective, is a divine function, and as creatures are the instru- 
ments of the Creator, there is nothing to be ashamed of by 
those who have complied with the usages of civilized peo- 

(315 ) 



316 HOME TREATMENT. 

pies, and wherever an exhibition of pregnancy becomes in- 
delicate, a person who hopes or expects to be a mother 
should not be. If a woman has the true characteristics to 
make a good mother, she cannot, nor will she trifle with her 
own health or that of her child ; in truth, mothers cannot 
begin too soon to consider the welfare of their offspring. 

To guard against taking cold is one of the maxims, that 
the pregnant woman should heed, especially during the last 
half of gestation when the prominence of the abdomen 
shortens the skirts in front and removes them off from the 
limbs. Flannel drawers properly adapted to the limbs and 
worn underneath the muslin ones affords the best protection 
that can be adopted, and it replaces cumbersome skirts. 
Sudden extreme variations of temperature should also be 
avoided, like going from an overheated apartment into the 
cold outside air, or into another cold chilly room. In mak- 
ing these changes, one should gradually cool off, and then 
by putting on additional clothing, wraps or shawls, the dan- 
ger of taking cold may be removed. Hot coffee or tea or 
hot alcoholic beverages are equally as dangerous as over- 
heated apartments, for anything which stimulates the cir- 
culation of the blood in an inordinate degree is liable to 
produce a congestion of the placenta, and thus incite an 
abortion; hence fevers of all kinds are known to have 
brought about an expulsion of the fetus. On the whole, 
either very hot or very cold temperatures are to be avoided, 
for instance, prolonged staying in cold weather or lengthened 
exposure to the rays of the sun should be prudently guarded 
against by the pregnant female. Of course this is not to be 
construed as meaning, that she should not partake of exer- 
cise in the open fresh air — far from it, but the exercise 
shall not be forced or driven, it shall at all times be volun- 
tary and passive, so that when a tired feeling comes on, she 
can rest and refresh herself. The best time for these little 
walks is in the morning and evening in the summer season 
and in the middle of the day in cold weather. A rough, 



PRECAUTIONS TO PREGNANT WOMEN. 317 

uneven walk should be avoided because she may stumble; 
jolting in either street cars or wagon is equally pernicious. 
A great deal of stair climbing is injurious, and when it be- 
comes necessary it must be done slowly; running the sewing 
machine has caused many miscarriages. Avoid running, 
jumping, riding on horseback, and lifting heavy weights, 
hanging laundried clothes on lines, in facteverything that can 
strain the muscles, bear down, increase the intra-abdominal 
pressure and excite the nervous system. 

The prospective mother must resign her amusements at 
evening entertainments in crowded halls or theaters, in 
which the air becomes foul and overheated from large con- 
gregations of persons. Here she is also threatened to be 
jostled and jammed, and perhaps injured in other ways. 
Her sleeping apartments should be thoroughly ventilated 
through the day, and coition, if not entirely suspended, at 
least restrained and only passively exercised, for any excess 
of this nature is not only injurious to the child, but may 
cause a miscarriage. It is not expected that the pregnant 
woman should sit in the arm chair during the period of 
gestation, far from it, but it is even greatly desired that she 
continue her usual vocation. Exercise of a passive nature 
is always wholesome, and for this reason it will be condu- 
cive to good health if enough work is done over every day 
to keep the system in gentle activity; the domestic duties of 
a household will or should always furnish that. All good 
women take a pride in their household affairs, if they do 
not they are not good ; and those who boast that they never 
put their hands to anything in the house, have mistaken 
their vocation as women, and are either indolent or worth- 
less, and often both. No one should boast of idleness, 
rather be ashamed of it. Employment makes character; it 
gives buoyancy to the spirit and tranquillity of mind. The 
influence that an equable temperament exercises over the 
nervous development of the unborn child may eventually 
be demonstrated by its resistance to the shock of diseases 
which superinduce convulsions and death. 



318 HOME TREATMENT. 

It is not advisable to sleep during the day, it is better to 
retire early after a light supper, so as to rest a few hours 
before midnight. This makes one fresh and spry in the 
morning, being on hand early in the morning, it gives 
ample time to dispose of domestic duties, and thus avoid 
confusion and rushing during the day. 

Cleanliness is one of the cardinal virtues of the pregnant 
woman — as pregnancy will be followed with childbirth, and 
as cleanliness is but another name for antiseptic, and that will 
guard against childbed fever, the importance of cleanliness 
springs at once into unusual prominence. No person can be 
filthy and slovenly during the entire period of gestation, and 
then at the moment of confinement become clean, even if 
in the last moment the person becomes bathed and brushed, 
everything else around and about her is soiled and dirty, 
unless she be taken to a lying-in home. Cleanliness must 
be cultivated, and finally it becomes second nature. The 
daily ablution of the external genitals should not be neglected, 
and general bathing in water not altogether too warm, say 
90 to 94 degrees F., twice a week will prove beneficial in 
many ways. The linen that is worn, and that which is in 
the bed should be kept sweet and clean, and cleaner than 
ever on the day of confinement. 

The mammse of the pregnant woman are sometimes very 
painful; as pregnancy advances they enlarge, the lacteal 
glands become congested and swollen. To relieve this I 
recommend the application of a liniment of equal parts 
camphorated oil, laudanum, and tincture of belladonna 
gently applied several times a day. The breasts should 
always be extra well covered with flannel so as not to take 
cold in them, otherwise an abscess may form in them long 
before the child is born. If the nipples are sensitive it is 
advisable to begin to harden them during the last few months 
of gestation. Tannate of glycerine is perhaps the best thing 
to apply for this purpose; it is best done by means of a small 
camel's hair brush. If the nipples are sunken into the 



PRECAUTIONS TO PREGNANT WOMEN. 319 

breast, and too short for subsequent use for the baby, it is 
well to draw them out by means of a breast pump, the bowl 
of a new clay pipe, or by employing a bottle from which the 
air has been replaced by filling it with hot water and then 
pouring it out; the mouth of the hot bottle is applied over 
the depressed nipple, and as it cools off, the vacuum thus 
formed draws the nipple out. 

Nausea and vomiting in pregnancy is often so annoying 
and weakening that the strength of the patient becomes 
seriously threatened, and hence some measures must be 
employed to counteract it. A great variety of agents have 
been suggested for this purpose. Tincture of nux vomica in 
two or three drop doses every three or four hours is a useful 
remedy; the oxalate of cerium is another valuable agent for 
this purpose, in five to ten grain doses three times a day, but 
a more valuable remedy than any other that I know, is the 
Femina vaginal capsule, to be used every night at bedtime, 
and in severe cases, also in the morning. 

Salivation is not constantly an attendant upon pregnancy, 
but when it does occur it is weakening and debilitating. 
There are many remedies for this disorder, but one of the 
most effectual ones is an occasional dose of Epsom salts, say 
a teaspoonful in a half tumbler of water every other morn- 
ing, so as to produce free discharges from the bowels ; when 
salts are found objectionable, the Femina laxative syrup 
taken in doses that have a similar effect will be a most excel- 
lent substitute. 

Constipation is one of the most common derangements 
of the pregnant woman; it is the rule in which the exceptions 
are few and far between. I do not include those cases of 
costiveness which are habitual, and which are to be attributed 
to carelessness in not responding to nature's call when there 
is an inclination, but to those in which constipation is con- 
temporaneous with pregnancy. We have already seen the 
sympathy between the stomach and other organs in preg- 
nancy, and that a similar derangement should exist between 



320 HOME TREATMENT. 

the uterus and rectum is not at all unreasonable, and, indeed, 
it can be explained in that way. In the early months of 
pregnancy, the torpor of the bowels may be due to the gen- 
eral derangement which follows digestive disturbances ; in 
the latter months, the enlarged uterus presses against the 
large intestines, so as to obstruct more or less the descent of 
the feces into the rectum. This torpor of the bowels should 
not be allowed to be unrelieved, for if permitted to continue 
it may not only induce a miscarriage, but it is apt to cause 
fever, headache and loss of appetite. Harsh cathartics 
must not be employed; and if a simple enema of warm 
water early every morning does not give the desired relief, I 
would recommend a daily dose of Femina laxative syrup. 
If it is found that in attempting to administer an enema, the 
fluid is immediately returned, then it will probably be owing 
to lumps of fecal matter which clog up the rectum; this 
will likely give rise to more or less straining or bearing 
down in the back passage, and to pains in the pelvis and 
lower limbs, all of which is not without danger of exciting 
premature labor pains; the fecal lumps must be removed 
even if it becomes necessary to use the finger. 

Diarrhea is the opposite condition of things, namely a 
looseness of the bowels. This may be occasioned by im- 
proper food, cold or any other cause capable of producing 
diarrhea when pregnancy does not exist. Habitual costive- 
ness is often followed by diarrhea from the irritation which 
the hardened feces excite. A dose of castor oil is sometimes 
an efficient remedy for this variety of diarrhea, but when the 
disease becomes obstinate and painful, the following remedy 
can always be depended upon for relief: — 

Take: Tr. of catechu. 

Tr. of kino, of each 4 drams 

Paregoric . ; 1 ounce 

Chalk mixture . 2 ounces, 

Mix and take a tablespoonful every four hours until 
relieved. 



PRECAUTIOUS TO pregnant WOMEN. 321 

Bladder trouble is not infrequent in the early and last 
stages of pregnancy; the causes of this were pointed out 
when the symptoms of pregnancy were inquired into. 
Recipe No. V is sometimes very useful to relieve this irri- 
tability, or a Femina vaginal capsule introduced into the 
vagina every night at bedtime, is sure to give the desired 
relief. 

The kidneys of pregnant women should not be neglected. 
On this question Dumas, an eminent French authority, says: 
"Physiological pregnancy, by modifying the quality and 
quantity of the blood is a predisposing general cause of 
albuminuria or Bright's disease. But to produce the last a 
cause must be added, and this may be due to a true patho- 
logical state of the blood, a morbid condition of the kidney, 
an accidental cause or mechanical pressure exerted by the 
uterus, where it has acquired a sufficient size." If the 
pregnant woman notices that her urine becomes thick and 
foamy, that her head aches and her limbs swell, she should 
pay particular attention to keep her bowels free, and besides 
drink a cupful of buchu tea every night at bedtime. 

Palpitation of the heart is a source of great annoyance 
to some women in the earlier months of pregnancy. Women 
of a nervous temperament and those who are of a full ple- 
thoric habit are most likely to suffer from distressing palpita- 
tion. Nervous women should take ten grains of bromide of 
sodium in half tumbler of water at bedtime, and only a 
very light supper, while those who are full blooded should 
keep their bowels freely opened and remove all pressure 
from the chest and abdomen by wearing the clothing loose. 

Pain in the abdomen walls from the sixth to the ninth 
month is particularly apt to occur in the first pregnancy. 
The abdominal walls offer a firm resistance to the growth of 
the uterus, and being thus put on the stretch by the com- 
bined development of the child and the womb, the muscles 
and skin become excessively tender and painful. I have 
recommended for this complaint: — 
21 



322 HOME TREATMENT. 

Take: Tr. of opium (laudanum). 

Glycerine, of each 1 ounce 

Mix and apply by means of gentle friction every night 
at bedtime or night and morning. 

Itching of the external organs will sometimes make the 
life of the pregnant woman miserable. I have seen it in so 
aggravated a form that the constant scratching to which the 
patient had recourse in the hope of being relieved, lacerated 
the parts so that they became ulcerated. The causes of this 
condition are numerous, the patient from motives of delicacy 
conceals her suffering until she can endure it no longer. It 
also happens that pregnancy has nothing at all to do with 
the itching for it may be due to diabetes, inattention to per- 
sonal cleanliness, the presence of small parasitic insects, acrid 
discharges from the vagina, or from pinworms in the rectum. 

If owing to parasites, mercurial ointment will cure the 
disease, if from vaginal discharges warm vaginal douches 
in which the Femina antiseptic tablets are dissolved will be 
the efficient remedy, and after a thorough ablution, the appli- 
cation by means of a camel's hair brush of a solution of 
cocaine will relieve the itching. 

Hemorrhoids, or piles, frequently torment the pregnant 
female beyond reasonable endurance. Piles may be either 
external or internal, in either case they are exceedingly apt 
to be very painful. When they occur in pregnancy they are 
due, in the first place, to an obstruction to the free return of 
blood to the heart by the enlarged uterus pressing on the 
large venous trunks and secondly, to constipation, which as 
we have learned is so frequently an attendant upon preg- 
nancy. If the piles bleed it may give temporary relief, but 
if the bleeding occurs too frequently, the patient becomes 
pale and weak from the loss of blood. I know of no painful 
and troublesome malady in which the application of a little 
common sense has greater brilliant results than in piles, yet 
of all maladies, with perhaps the exception of catarrh of 
the nose, it is the most abused by senseless and meddlesome 



PRECAUTIONS TO PREGNANT WOMEN. 323 

doctoring. The first stop to engage the attention of the 
patient is to regulate the bowels and overcome the constipa- 
tion; the passages must be kept soft and soluble, unless this 
is accomplished all the other efforts fail. The constipation 
must be partly relieved by proper dieting, and partly by 
suitable remedies. A simple bland diet, for a short time at 
least, is very useful; bread and milk, thin milk gruel, fruits 
and vegetables are to be preferred; abstain from solids, from 
meat and eggs and everything of the nature of beer and 
wine or alcohol, even coffee is irritating; while the disease 
is at its height eat sparingly of everything, but drink plenty 
•of water, warm or cold, but not iced cold. The bowels should 
be regulated by taking a mild, efficient laxative, none 
being better than the Femina laxative syrup. Another 
precaution, very essential to success, is that after each stool 
the parts are gently bathed and washed with tepid or cool 
water by means of a soft sponge; gentle pressure can be 
exerted at the same time so as to assist the piles to return 
into the rectum. If they cannot be returned in this manner, 
the patient must learn to use her index finger and with it 
oiled with a little sweet oil or vaseline the piles are gradually 
shoved back into the rectum which alone relieves the suffer- 
ing, because it relieves the strangulation and swelling which 
the sphincter muscle of the rectum causes. The pushing 
back after each stool and even between times is one of the 
essential features of a successful home treatment for piles, 
and it must be kept up for years, if necessary, to insure com- 
fort and to guard against a relapse. Better than plain oil 
or vaseline is the nutgall ointment to be had at any drug 
store, but if the pain and distress continue use the following 
recipe: — 

Take: Cocaine. 

Ex. Belladonna, of each 10 grains 

Vaseline 4 drams 

Mix and make into an ointment ; apply to the piles at 
bedtime or whenever they come down and have to be re- 



324 HOME TREATMENT. 

turned; a few days in bed will materially aid in the recov- 
ery. 

The diet of the pregnant female should be made a special 
study for upon the regimen of food not only depends her im- 
mediate comfort, but its ultimate effect on the process of 
parturition is equally marked. I do not agree with the 
opinion, laid down by some of the highest authorities, that 
"as far as eating and drinking is concerned, the pregnant 
woman may continue her accustomed diet." I believe that 
there is a diet peculiarly adapted to the pregnant woman 
and very beneficial to her if she lives up to it. Stimulants of 
every kind are not good; wine, beer, whisky and even 
strong coffee and tea, as well as highly seasoned food, salty 
or sour salads should not be eaten. 

How very often does it happen that a very strong, muscu- 
lar, robust, healthy young woman, who, during her entire 
period of gestation, was in the best of health and spirits, and 
from whom, from all appearances one may predict that she 
will have an "easy time" in her confinement, quite the 
opposite occurs. And why as a matter of fact and expe- 
rience is this not so, is indeed an interesting inquiry. I be- 
lieve that the answer to this question can be made so plain 
and reasonable, that a mere statement of a few simple facts 
will make it apparent. 

The process of delivery, presupposes the contraction of 
the uterus and the descent of the child down into the pelvic 
canal and its further passage through the floor of the pelvis. 

The pelvic floor (see page 228) forms the bottom of the 
pelvic canal through which the child must be forced. The 
vagina is the opening through this floor, and this is com- 
posed of the muscles and membranes of the vagina, the skin, 
two layers of fascea, the triangular ligaments of the bladder 
and a group of interlacing muscles. In the birth of the 
child all these tissues are forced to relax to such an extent, 
that the vaginal canal (or the vagina) will be sufficiently 
widened or dilated to allow the child to pass through into 



PRECAUTIONS TO PREGNANT WOMEN. 325 

the world. A moment's reflection will at once make clear, 
that in a strong muscular person, the resistance to the neces- 
sary dilatation will become correspondingly great, because 
the muscles are so strong and tense. I have attended some 
women where the muscles under the excitement of labor 
pains felt as tense and hard, as though they were made of 
strong india rubber. It is apparent that the muscular 
resistance that is offered by these strong, tense muscles, 
clearly obstructs and delays the passage or birth of the child 
and it makes the strongest labor pains of no avail. And ex- 
perience teaches, that the progress of labor is slow and the 
delivery generally prolonged until the pains and physical 
suffering of many hours, exhaust and relax the muscular 
resistance so that the child is allowed to pass. If the above 
truths were generally understood and generally recognized 
they might be guarded against by a proper dietetic regula- 
tion, and thus an infinite amount of suffering could be 
avoided. 

Painless childbirth is only relative, and in the absolute 
meaning of the term it is not true, and for this reason, that 
severe contractions of the womb are always painful, and ex- 
treme tension of tissues and muscles such as the passage of 
the child will occasion in its passage through the soft parts 
is also more or less painful and there is no natural child- 
birth possible without both these factors being present. 
Painless childbirth in its absolute sense, as a scientific fact, 
is not true, but to assure a comparatively painless childbirth 
in accordance with scientific facts which are capable of dem- 
onstration is not only reasonable but absolutely true. 

The term "food" is understood to be all those substances, 
solid and liquid, which are used for the process of nutrition. 
For our present purpose foods may be divided into three 
classes: carbo-hydrates, albuminoids, and phosphates. 

The carbo-hydrates furnish fat and warmth, as an exam- 
ple we have starch, sugar, and fats. Persons who are fed 



326 HOME TREATMENT. 

principally upon this class become warm and fat, but will 
lack muscle and nerve. 

The albuminoids are also termed nitrogenous substances, 
and constitute the muscle making material. They are de- 
rived both from animal and vegetable sources, and in their 
most concentrated form we find them in eggs, milk or cheese, 
and in meats also in certain meals; wheat, for instance, con- 
tains fourteen per cent of nitrate or muscle-making material. 

Phosphates are generally taken into the system as phos- 
phate of lime contained in certain foods we eat, as fish, lob- 
ster, beef, Southern corn, peas and beans, barley, sweet 
potatoes and oats. 

It is obvious from what was said of painful and prolonged 
childbirth, that the pregnant woman should avoid as much 
as possible nitrogenous or muscle-making food; she must 
starve her muscular system as much as it is possible for her to 
do, and the result will be that her muscles will become soft 
and relaxable and that means a comparatively easy or pain- 
less childbirth. In Europe, the peasantry who eat meat 
sparingly or very seldom, have comparatively little pain, 
because vegetables enter largely into their daily diet; the 
same is true in Asiatic countries where the staple is rice,, 
the throes of labor are very light. The squaws of our Indian 
tribes are remarkable for the little pain they suffer in child- 
birth and for the shortness of its duration, and the recuper- 
ation is also a speedy one, for an Indian woman will travel 
or be about in a few days after her confinement with her 
pappoose on her back. 

I would recommend to the pregnant woman to live as much 
as it is possible for her to do on a fruit and vegetable diet. 
Her meals must be taken at regular intervals, otherwise 
derangement of the stomach is sure to follow. Excess in 
eating even the plainest kind of food must be studiously 
avoided, and all food must be eaten slowly and thoroughly 
masticated. Wheaten bread or rice and milk diluted with. 



PRECAUTIONS TO PREGNANT WOMEN. 327 

water should form the main diet Thoroughly cooked garden 
vegetables and fresh, ripe fruit like apples, grapes., peaches, 
plums, etc., should be used in summer, and some of the same 
fruits canned in winter, or dried fruits slowly simmered until 
they are soft; it is always better to soak dried fruit for several 
hours or overnight before it is put over to boil. 



CHAPTER XXVIII. 

WHILE IN CHILDBED. 

By childbed is usually meant the period of delivery, but 
I mean to include the lying-in period, from the moment 
the mother has the first signs of her approaching delivery, 
to the time when she is supposed to have fully recovered 
and is able to be out of her bed and about. 

If the suggestions that were thrown out in a former chap- 
ter are complied with, there will be little reason for un- 
easiness for the prospective mother, but it will be conducive 
to her welfare if she be buoyant in spirit and hopeful of the 
best possible result. 

The nurse should be a quiet, orderly woman, and neither 
too young or too old; she should have had experience in 
nursing during confinements and taking care of newborn 
babies; with all this she should not be set in her ways, but 
should be accommodating and active, so that she will carry 
out conscientiously the instructions of the attending physi- 
cian. 

The choice of a physician should not be delayed until 
the last moment, but it should be made several months be- 
fore the expectation of delivery, and a woman should never 
engage a doctor for her confinement, unless she knows that 
he has had practical experience in at least ten cases of con- 
finement, for some of our leading medical colleges and all of 
the poor ones, graduate hundreds of doctors each year who 
never attended a single case of confinement, and some have, 
even, never seen one; yet the newly fledged doctors are 
turned loose upon the unsophisticated communities to attend 
women in the most trying period of their lives, and at a 
(328) 



WHILE IN CHILDBED. 329 

time when both the experience and science of her physician 

should be her sheet anchor of hope. A physician who is 
not always sober, of good moral character, and cleanly in 
his habits and appearance, should never be allowed in the 
lying-in chamber, nor one who is prating of the many severe 
confinements he has attended, or who boastingly speaks of 
the number of times it was necessary for him to use instru- 
ments, for it is quite likely, that the many severe confine- 
ments of which he spoke, were either fictitious or due to his 
ignorance of the subject, and the frequency with which 
he used instruments was owing to a lack of patience on his 
part or to a desire to be meddlesome and make himself of- 
ficious. There are a great many medical gentlemen who 
are not charlatans in disguise, and these should be singled 
out. The pregnant female should have herself thoroughly 
washed and bathed just before confinement, and the vagina 
should be thoroughly rinsed out with half a gallon of warm 
water in which a tablespoonful of pulverized borax has 
been dissolved; this precaution will wash out any infectious 
germs that may cause inflammation. 

The bed in which the confinement is to take place should 
be scrupulously clean, and in order to insure this, it should 
be made a rule that the bedstead be taken apart, and taken 
out-of-doors where it is thoroughly washed and afterwards 
exposed to the purifying influence of the sun and air. The 
mattress must also be taken out for a similar dusting and 
cleaning, and kept for a time exposed to sun and air. The 
confinement chamber should go through the same renovat- 
ing ordeal; the carpet of this particular chamber should be 
taken up, the floor thoroughly scrubbed and the walls and 
ceiling washed off and whitened. It will be better if a few 
clean mats or rugs can be substituted, and the old carpet 
not relaid until after the confinement, when the woman is 
up and around again. These precautions will guard against 
the possibility of infection and the dangers of childbed fever, 
and the many different phases of inflammation which are 



330 HOME TREATMENT. 

the result of carelessness in the details of cleanliness. Of 
course, the nurse and attending physician must be equally 
anxious of their own personal cleanliness. If he or she 
leave any of the infectious diseases, like scarlet fever, mea- 
sles, typhoid fever, erysipelas and puerperal fever, either of 
them is quite sure to communicate the contagion to the in- 
nocently ignorant lying-in woman, and entail upon her 
endless suffering and death. In France and Germany, 
stringent precautions for nurse and physician against the 
dangers of infections are mandatory under the laws, but in 
free America such legal injunctions would be considered as 
curtailing our liberty; in the meantime, innocent lives are 
sacrificed, through lack of systematized regulations, at the 
cost of liberty degenerating into license. 

On the day of confinement the bed is held in readiness 
for the occasion, by spreading over the mattress a large 
piece of oiled cloth, or what is preferable, rubber cloth; this 
must reach up high enough so as to afford proper protection 
and lap over the side of mattress and bedstead. Beside the 
bed an extra mat should be laid, to catch any fluid that 
may run down the rubber cloth on the floor. 

The preliminary signs of labor pains that make them- 
selves felt by the pregnant female, are of considerable inter- 
est to her and I believe, that if she will familiarize herself 
with their character she will have less anxiety and more 
confidence in a happy termination of her condition. For 
some days, and occasionally for two or three weeks prior to 
the commencement of actual labor, a sense of uneasiness 
about the uterus will be felt by the female; this uneasiness 
will be observed several times during the day and night. 
When the patient complains of this local disturbance, she 
may feel, by placing her hands over the region of the womb, 
that the organ becomes hard for the time being, and as soon 
as the sense of uneasiness passes away, the womb becomes 
soft again. These symptoms are called the "independent 
contractions of the uterus" and in the first pregnancy they 



WHILE IX CHILDBED. 331 

are felt earlier than afterwards. This is simply a muscular 
irritability of the womb and is not accompanied by "bear- 
ing down" which is the true characteristic of labor. These 
preliminary skirmishes must not be mistaken for the com- 
mencement of labor, otherwise great mischief may be done 
by harassing the case into a premature delivery which 
might sacrifice the child. The pregnant female will often 
become very anxious when she first experiences these inde- 
pendent pains and she may imagine that something is 
wrong; for this apprehension there is no reason, because ex- 
perience has taught that the greater this local disturbance 
before the beginning of labor, the more favorable the prog- 
ress of labor will be when true labor pains set in. 

"The righting of the organ" will be observed for some 
days previous to the confinement, by a change of the position 
of the pregnant womb. The womb places itself, as it were, 
in readiness for the expulsion of the child, which is shortly 
to begin. This is done by the body of the uterus inclining 
forwards and sinking downwards, and correspondingly 
relieving from pressure the organs of the chest; this makes 
breathing easier, and in proportion as the body of the womb 
comes down, so will the lower portion of the organ descend, 
and this ma} r give rise to irritation of the bladder and fre- 
quent desire to pass water; sometimes the passage of urine 
may be entirely obstructed, so that the water must be drawn 
off by means of a catheter. Some women become very 
nervous just before the commencement of labor; this is gen- 
erally due to fear or anxiety, for which there is no reason, 
and agreeable companionship will generally dispel all evil 
forebodings and restore her to self-confidence. 

Labor pains are divided into true and false, and this dis- 
tinction is entirely based upon their different sources. 
True labor pains are due to the contractions of the muscles 
of the uterus, and at the beginning they are slight. They 
commence in the back and run on dowm to the thighs; one 
feature about them is that they are intermittent, that is, 



332 HOME TREATMENT. 

that they are not continuous; there is always an interval, 
especially at the beginning of labor, in which there is no 
pain at all. When labor sets in, the pains are grinding or 
cutting, but as soon as the mouth of the uterus is fairly 
opened or dilated, the character of the pain changes to a 
bearing down or forcing out nature. If the hand is applied 
over the region of the womb, during the presence of a pain, 
the organ can be felt hardened and swollen; this subsides 
with the pain, and in the interval, the organ relaxes. This 
is a wise provision of nature, for it gives the woman an oppor- 
tunity to recover and regain fresh strength for each succeed- 
ing effort. False labor pain has no connection with the proc- 
ess of childbearing, but is only an incidental complication. 
It may be caused by gas in the intestines, indigestion, 
diarrhea, constipation, disease of the kidney, neuralgia, or 
rheumatism of the muscles of the abdomen or bowels, and 
by the passage of gallstones; where the false pains have been 
traced to their origin they can be properly dealt with. 

A muco-sanguineous discharge from the vagina is 
another sign that labor has begun, but it will sometimes 
happen that it is absent, and this constitutes a dry labor. The 
mucous discharge which is thus observed, subserves a very 
important object in lubricating the parts and relaxing the 
neck of the womb and the vagina. There is often a slight 
tinge of blood, due, perhaps, to a rupture of small blood ves- 
sels in the mouth of the womb; this is called a show, which 
some women have for several days before labor commences. 
" Stages of labor" are arbitrary divisions, so as to simplify 
the explanation of the entire process of labor from the time 
the womb begins to act, up to the last act of parturition, 
which is the expulsion of the afterbirth, and these have 
usually been divided into three stages. The first stage is 
the dilation or opening of the mouth of the womb, includ- 
ing also the breaking of the membraneous sac which holds 
the fluid in which the child floats, so as to protect it from 
pressure that the walls of the uterus would be continually 



WHILE IN CHILDBED. 333 

exercising, which would prevent its proper development, 
In this stage the woman should not exert herself by bearing 
down; this will only waste her strength which she should 
preserve for the second stage, when the mouth of the womb 
has opened and the progress of the child into the world has 
commenced ; during this stage, the female should make an 
attempt to relieve her bladder, and if she has had no stool 
for several hours before, it will be a good thing to use an 
enema of warm water, and empty the bowels. 

The second stage of labor begins when the bag of water 
has broken and the waters escape; the contractions of the 
womb increase now in violence and become decidedly of a 
bearing down character. At this period the patient should 
be furnished with something that she may grasp with her 
hands; a sheet attached to the post of the bed is the best for 
this purpose, and with her feet steadily braced, holding her 
breath she bears down whenever a pain comes on; bearing 
down between pains, only exhausts the patient and does no 
good. During this stage of labor, the pain in the patient's 
back will sometimes become intense, she exclaims : Oh, dear, 
doctor, my poor back feels like breaking! what shall I do? 
The greatest relief that can be given at this time is to sup- 
port the back with the flat surface of the hand, or by fold- 
ing a towel and placing it under the back, the two ends 
being held by assistants. 

As the birth of the child progresses and it approaches the 
vulva, the patient will feel an urgent inclination to go to 
stool; upon this she must not insist, for at this advanced 
period of labor she may injure herself and child. The 
desire is caused by the pressure of the child's head against 
the rectum; any fecal matter that is thus pressed out should 
be at once removed by the nurse. 

The third stage of labor consists in the expulsion of the 
placenta or afterbirth. 

There is a natural detachment of the placenta and a nat- 
ural expulsion, but one must have the patience to wait. 



334 HOME TREATMENT. 

What presumption of the officious doctor or midwife to sup- 
pose that nature was so derelict as to require some meddle- 
some assistant, immediately after the birth of the child, to 
drag or pull on the placenta: no, more than that, carry the 
hand up into the cavity of the womb and detach the placenta 
with the fingers and bring it down and out. When I first 
started out to practice I was foolish enough to believe and 
do the same thing, and afterwards I congratulated ■ myself 
how wonderfully skilled I was, but now I am convinced that 
this procedure was due to ignorance of the laws of nature. 
The truth of the matter is, that the sooner and the more one 
pulls and feels on the placenta, the more irritable the womb 
becomes, and the more will the uterus contract, as though it 
protested against interference. 

I have had it happen, and others must have had the same 
experience, that the womb closes and contracts firmly in ten 
to twenty minutes after delivery, the afterbirth becoming 
tightly inclosed so that one not experienced would be fright- 
ened into the belief, Oh ! here the placenta has grown to the 
womb. This is a delusion which may lead to an interfer- 
ence that may entail dangerous consequences to the mother. 
The condition is simply this, that as the afterbirth was not 
completely detached at the birth of the child, the uterus con- 
tracted immediately upon and around the retained placenta, 
and for two physiological reasons : (1) to accomplish the very 
object which was imagined was not accomplished, namely, 
by contracting, the uterus naturally peels itself off from the 
placental attachment, and (2) were it not for this immediate 
contraction of the uterus after the expulsion of the child, 
the mother would likely flood from the uterine vessels of the 
partly detached placenta. Of late years I never experienced 
a single case in which the placenta did not detach itself, and 
if I had known twenty years ago as I do now, I never would 
have had one. 

After the delivery of the child, the woman should be 
made as comfortable as possible for the time being, and 



WHILE IN CHILDBED. 335 

by the time the child is washed and dressed, the placenta 
will generally present itself in the vulva. If the afterbirth 
has not come away at once there is no need to become 
alarmed. I have waited for six to eight hours for that event 
to take place, and if there is delay over an hour, two tea- 
spoonfuls of fluid extract of ergot will so excite contractions 
of the womb that its contents will be expelled. 

Whether the afterbirth comes away immediately after the 
birth of the child, or is delayed, it must not interfere with put- 
ting the mother in a warm, dry, comfortable condition. 
Everything that is damp from perspiration or wet from the 
waters, both dress and bed linen must be removed and re- 
placed with warmed, dry, clean linen; this insures against 
taking cold. To me it looks like a crime against science and 
nature to allow a woman to remain in the wet and soiled bed 
after her confinement for twelve or more hours, and the doc- 
tor or nurse who permits this, is ignorant and negligent of 
his duties. 

After the placenta is removed, the binder or bandage is 
applied; this is simply a piece of unbleached muslin about 
eighteen inches wide and long enough to reach one and a 
half times around the body ; it should be brought down to 
cover the hips and then fastened with strong safety pins. 
The object of the binder is to give support to the flabby and 
relaxed abdominal muscles, which is a great comfort and aid 
to restore the muscles to their former shape. 

How a woman should lie after confinement is of much 
greater importance than how she should lie during child- 
birth ; in fact it does not matter much how she lies during 
labor so long as she feels comfortable, but after confinement 
and during her convalescence, her position in bed has an 
important bearing on her recovery; to avoid repetition I refer 
the reader to pages 73 and 250 of this work. Vaginal 
douches of hot water, of a temperature of 104 degrees F. serve 
a very useful purpose in washing out the secretions that 
will naturally accumulate in the vagina, and after a short 



336 HOME TREATMENT. 

time undergo septic decomposition ; these rinsings also assist 
nature to repair and heal the tissues. The quantity of fluid 
that should be used at once is half a gallon of water in which 
a tablespoonful of powdered borax has been dissolved. 
Great care should be exercised by the nurse, lest the bed 
and linen of the patient get wet, and through this she become 
liable to take cold. The second day after the delivery is 
about the right time to begin using the douche, and about 
this time the mother should also get a mild laxative, either 
of castor oil or of Femina laxative syrup, which is very pala- 
table and suitable for the occasion. 

The last throes of labor which usher the child into the 
world constitute the climax of the parturient effort and as 
there is little or no interval between the pains, the pains 
at this period have been appropriately termed double labor 
pains. There is more or less excitement and apprehension 
on the part of the lying-in female and the experienced prac- 
titioner or nurse will concentrate his effort to calm and en- 
courage the sufferer in the last minutes of her travail. 

It is best to wait a few minutes after the child is born 
before tying the cord, so as to give the circulation time to 
equalize itself; especially is this desirable when the cord was 
wound around the child's neck or when it is otherwise com- 
pressed. The cord is tied about an inch above the navel, 
and half an inch higher the cord is cut with a pair of sharp 
scissors. In the meantime, the nurse, if properly instructed, 
will have in readiness on the side of the bed a warm flannel 
or blanket which is to receive the little stranger. There is 
a proper way to pick up a newborn babe, so that it will not 
roll or slip from the hands, which I have known to happen. 
The little baby must be taken hold off with the same gentle 
firmness as an older child. To prevent any accident, place 
the posterior surface of the child's neck in the space bounded 
by the thumb and index finger of one hand, and with the 
other hand gently seize the thighs and in this manner place 
it into the blanket, to be conveyed to a warm place of safety, 



WHILE IN CHILDBED. 337 

— the newborn child must be kept warm, for its very life 
may depend upon it. After the mother has had her tempo- 
rary wants satisfied, the nurse prepares for the first toilet of the 
child. 

The care of the baby is differently understood by differ- 
ent persons, and as a result of this difference of opinion I 
have observed a great many unfortunate consequences. 
There is no reason why the care of the baby should be resigned 
to custom and habit for both are often extremely hazardous 
to the life of the child, and this I will illustrate in the course 
of my remarks. 

How often are newly born infants taken into a cold room 
in which, from the arrangement of the doors, a draft sweeps 
through whenever a person goes out or comes in? How the 
child is laid bare in readiness for the ordeal of a thorough 
cleaning! The child is generally first rubbed with oil and 
afterwards put into a bath tub or some other vessel of suffi- 
cient capacity to drown several babies at once. It is now 
treated to a soaping process, after which, by means of a 
cloth indifferently selected, the child is scrubbed with an 
ambition which would have been laudable if applied to the 
nurse's own person, but why this little innocent should be 
the object of such abuse has been a standing wonder to me 
from the time I witnessed the first outrage. By the time the 
nurse gets through bathing the child, it is shivering and 
blue from cold. I had not been practicing medicine very 
long before I became appalled by this barbarous procedure, 
nor had I practiced very long before I was called upon to 
sign a number of death certificates of infants who contracted 
colds that resulted in bronchitis, pneumonia and congestion 
of the lungs, which caused their death. 

There is no sense in this dousing and soaping of a new- 
born child, and aside from its danger by undue exposure, it 
is absolutely useless. But habit is often so thoroughly in- 
trenched that the good judgment which persons exercise in 
most of their duties may become entirely suspended, when 
22 



338 HOME TREATMENT. 

this force of habit has established a custom that is well-nigh 
universal. 

My method of directing the first toilet of the baby is 
without the possible dangers to which I have referred, for it 
has for its object not only to clean the child, but to dress 
it as quickly as possible and again wrap it in flannel. 
Warmth is the life of the newborn babe; it does not re- 
quire much food, if any, the first twenty-four or forty-eight 
hours of its life, but it requires to be kept warm. The room 
in which the child is to be cleansed must be warm and free 
from draft, and if there is a fire in the chamber where the 
mother is, the toilet of the child had better be made here 
under her eyes and those of the physician. The nurse or 
person delegated to dress the baby provides herself with a 
vase or bowl of warm water and a saucerful of warm olive 
oil or vaseline and a few soft cloths. She then seats herself 
in a low chair, and by means of a small piece of flannel she 
applies the oil all over the baby's body, rubbing in an extra 
quantity in the armpits, groins and other places where the 
cheesy substance is thickest. When the oil has softened the 
sebaceous material, take a soft muslin cloth, provided for 
the purpose, and beginning on the head the oil is wiped off 
again ; where there are blood stains left, wash these off with 
a soft flannel cloth ; at the same time the eyes are to be bathed 
and the mouth washed out. I have not mentioned the use 
of soap, for the reason that it is not at all necessary and very 
often injurious. The oil removes all the caseous matter and 
what oil remains is rather an advantage than otherwise; 
it preserves the warmth of the child and protects its skin. 
If the soap comes in contact with the eyes of the infant it 
often becomes a fruitful source of that annoying and often 
dangerous disease of the eyes that is technically termed 
purulent ophthalmia. 

Never apply oil or any other greasy substance to the 
cord before it comes off, for this will prevent its drying and 
delay its falling off. When the cord has come off, you 



WHILE IN* CHILDBED. 339 

simply keep the navel clean by washing it daily with a Little 
warm borax water and afterwards apply a small compress on 

which lias been smeared a little zinc ointment. Always see 
to it that the baby is lying dry and use dusting powder 
freely; the precipitated chalk is the best and cheapest infant 
powder that can be used. The child that is nursed on its 
mother's breasts has little to fear from overfeeding, yet it 
should not be allowed to hang on the nipple too long or 
sleep with the nipple in its mouth. Nurse the child every 
two hours during the day and awaken it if it should sleep 
to give it its nourishment, but at night allow it to sleep as 
long as it wants to; this will cultivate regular habits in the 
child and it will thrive much better. If the baby cries and 
is restless between times do not imagine that it is always 
hungry, but rather colicky, for which there is nothing better 
than the old German domestic remedy, fennel seed tea; of this 
give the baby all it will drink every day and until it is a 
year old. 

Sore nipples are a great annoyance to a mother and often 
very obstinate to treatment. The skin covering the nipple 
is made exeedingly tender by the sucking of the child's 
mouth and in a few days it cracks and becomes fissured. 
Sometimes, the pain that the mother endures whenever the 
infant nurses is excruciating, for every time the child is put 
to the breasts the cracks open anew. The most fruitful cause 
of this condition is to allow the child to hold the nipple in 
its mouth when it does not nurse or perhaps to allow it to 
retain the nipple in its mouth while it sleeps. 

This practice must be at once discontinued, and the child 
must be at once removed from the breast as soon as it is 
satisfied. The nipples should be washed with borax water, 
and then a salve should be made by mixing the yellow of 
one egg with half an ounce of Peruvian balsam. This is to 
be applied by means of a camel's hair brush to the sore 
nipple every time after the child is through nursing. Should 
the nipple be too sensitive and the suction of the child too 



340 HOME TREATMENT. 

painful, then a breast pump bad better be used for a few 
days and tbe child not applied until the teat has sufficiently 
improved. 

Abscess of the breast constitutes a distressing compli- 
cation of the puerperal condition, inflicting upon the pa- 
tient intense suffering, and very often leading to a long 
delay in recovery. It may be due to cold, and in one case it 
developed from this cause two months before confinement,, 
but this is an exception. Sore nipples are a fruitful cause, 
for the soreness of nursing makes the mother reluctant to 
have the child draw all the milk out, hence, the breast 
cakes and hardens with the above result. It also is due to 
neglect in not having the nipple properly drawn out; or to 
a foolish custom, derived from remote ancestry not to allow 
the infant to be put to the breast for two or three days after 
its birth. In this way the milk ducts become greatly dis- 
tended, inflammation sets in, which, if not properly arrested 
will terminate in an abscess. If gentle friction of cam- 
phorated oil and hot, moist compresses or poultices do not 
enable the child to draw out the secretion, a young pup 
should be obtained, for he draws with a gentleness and ac- 
tivity which surpasses the most perfect machine. The 
patient must drink sparingly of fluids and properly support 
the breasts by means of handkerchiefs placed under them 
and made to cross the shoulders, and the bowels should 
be thoroughly opened. Should an abscess form it should 
be opened by a free incision, and the poultice discontinued, 
but instead a wad of absorbent cotton should be applied and 
the breast tightly bandaged with the handkerchief. 



CHAPTER XXIX. 

DISEASES PECULIAR TO CHILDREN. 

The diseases of children that I propose to inquire into, 
are not those of so serious a nature as to require the skill of 
a physician, but rather those trivial ailments which are 
common among children of tender age and which neither 
good care nor healthy surroundings seem to be able to ward 
off. And for this reason, mothers and nurses should famil- 
iarize themselves with these ailments and their appropriate 
treatment, for trivial as they may seem to begin with, if 
permitted to go on uncontrolled, they often lead to more 
serious and perhaps fatal consequences. 

A coated tongue in children is not always a sign of 
digestive disturbance, for most nurslings have a white coated 
tongue in the first three or four weeks of their lives. With 
the ancients, and even up to within a recent period, the 
tongue was considered the mirror of the stomach; this was a 
delusion because nothing definite or of great importance can 
be deciphered in any case from the appearance of the tongue 
alone, but this superstition became so deeply rooted in the 
minds of the public, that even now a medical examination 
is considered incomplete unless the physician says put your 
tongue out, for the purpose of a physical inspection. 

When the child loses its appetite and the stomach and 
bowels become deranged, the tongue generally becomes 
coated. Children who are overfed and in whom the food 
is not digested, may have a thick fur over the tongue, but 
as a rule only on the back of the tongue there is a whitish 
coat. In diseases of the mouth that are purely local, the 
tongue is sometimes coated, quite independently of any disease 

" (341 ) 



342 HOME TREATMENT. 

of the stomach, as for instance in thrush, in catarrhal inflam- 
mation of the mouth, diphtheria, burns and other injuries. 

(a) Catarrh of the mouth is an inflammation of the mu- 
cous membrane and is recognized by redness and increased 
secretion. It is most intense on the tongue, which presents 
the appearance as though it were coated with raspberry 
syrup. Sometimes the redness is most on the inside of the 
cheeks and soft palate, while the tongue is covered with soft 
fur. The inflammation of the mucous membrane of the 
mouth, extends in aggravated cases to the throat and nasal 
passages and along the Eustachian tube into the ear. There 
is many a baby suffering, no one knows from what, when it 
has an earache due to this cause. When the catarrh has. 
existed for some time, clear, minute water-vesicles rise upon 
the tongue, gums and mucous membrane of the lips and 
cheeks. These burst and leave behind them small, flat ulcers, 
which in the first few days run together and present large, 
flat, ulcerated surfaces. The children become feverish and 
refuse to eat and drink for days, partly because to do so, pains 
them and partly from a loss of appetite. 

The most common cause is the eruption of the teeth. 
Mothers of experience know that when the baby drools, it is 
teething, and if she examines a little closer she will discover 
the catarrhal condition described. Another cause is the old- 
fashioned sugar teat with its souring contents; so is the 
nursing food, when either too hot or too cold, and in older 
children irregular or improper food has the same effect, for 
instance, sour ripe fruit eaten in excess. 

The treatment for catarrh of the mouth is simple and 
successful if directed to the removal of the causes that we 
have enumerated. The mouth should be cleansed every few 
hours with a little borax water, and the febrile symptoms 
generally subside with a dose of mild laxative. 

(b) Putrid sore mouth is an aggravated stage of the above 
affection; it begins on the borders of the gums as inflamed 
patches coated with a thin layer of yellow mucus. The 






DISEASES OF CHILDREN. 343 

slightest touch of the ulcerated places causes bleeding, and 

the affection can be recognized at quite a distance from the 
mouth by the sense of smell. The disease is contagious and 
may be imparted from one child to another. Carious teeth 
are the predisposing agents; mercury or calomel in repeated 
and large doses produces a similar effect. A very simple 
and efficient remedy for this affection is a saturated solution 
of chlorate of potassa, in the proportion of a teaspoonful to a 
teacupful of boiling water; with this solution wash the mouth 
out every two hours, and allow a little to be swallowed at the 
same time; children under one year of age can swallow ten 
drops; under two years, twenty drops; under three, thirty 
drops, and larger ones can take a teaspoonful. 

(c) Thrush, sprue, or soor is another type of sore mouth 
that falls to the lot of some children. It resembles 
catarrh of the mouth, but must be considered a different 
disease, inasmuch that it is proven to be due to a fungus 
growth. The disease begins with a change of color from the 
natural bright red, to a livid, dark red color; the entire 
mucous membrane of the mouth is uniformly discolored; 
the discoloration never occurs in spots, and the surface pre- 
sents the appearance as if a thick coat of raspberry syrup 
had been smeared upon it. The mucous membrane becomes 
dry and sticky and the secretion of the mouth is acid. On 
inspecting the mouth the fungi can be seen, at first as small 
white points if only existing a few hours, but their growth 
is very rapid, and they soon form large white patches, which 
may run together and cover the entire mouth. The treat- 
ment is directed towards removing the cause in the first 
place ; if the child has been using the sugar teat that must 
be discontinued, and even a milk diet should be suspended 
for a few days, on account of its containing sugar and cheesy 
matter, and instead the child should be fed with a little 
thickening of arrow root or wheaten flour. The mouth 
must be kept sweet and clean with a solution of borax 
applied with a small camel's hair brush; if the disease is 



344 HOME TREATMENT. 

obstinate, dissolve the borax in creosote water obtained from 
a druggist, and apply this every hour or two as above. 

(d) Parotitis, or mumps, is an inflammation of the parotid 
or salivary gland. The disease shows itself as a swelling 
between the angle of the lower jaw and the ear. Several 
days before the swelling and pain begin, the children feel 
tired, ill-humored, feverish, lose their appetite, lounge around 
or voluntarily take to bed. Nervous children show brain 
symptoms; they complain of headache, are delirious and 
have convulsions. After two or three days they begin to 
feel pain behind the jaw, and when they open the mouth, 
masticate, or on slight pressure, the pain becomes aggravated. 
The swelling over the corresponding cheek extends to the 
lower eyelid and back to the neck. The skin over the swell- 
ing becomes inflamed and red. In males the swelling may 
suddenly move from the neck to the testes, while in the 
female it may strike on the mammae. 

The course of mumps is usually favorable, but there is a 
possibility of an abscess forming, and this may break di- 
rectly outward, or burrow backwards and burst into the ear, 
perforating the ear drum, causing lifelong deafness. I have 
had one case in which the disease went to the brain ; the 
little boy, a child of seven, died. The patient who has 
mumps must be kept warm; over the swelling apply hot 
poultices for three or four days, and besides wrap the entire 
head and neck in flannel. If the swelling is painful, and 
the child in robust health, a few leeches applied to the swell- 
ing will relieve the pain and have a good effect on the cause 
of the disease. Belladonna ointment is a valuable remedy 
for older children, but with babies it must be used with ex- 
treme care. The diet must be bland and light; bread and 
milk , or gruel, is the most appropriate. Give a little paregoric 
at night to soothe the restlessness, and open the bowels with 
the Femina laxative syrup. 

(e) Tonsilitis or quinsy sore throat is often mistaken 
for the mumps, but to the experienced practitioner or nurse 



DISEASES OF CHILDREN. 345 

there is no resemblance, and to mistake one for the other is 
almost impossible. In tonsilitis the cheek never swells, the 
swelled tonsils being felt only behind the jaw and quite below 
the ear. Tonsilitis occurs oftener than mumps, and unlike 
the latter affection, when the patient has had one attack of 
quinsy he is likely to have a recurrence whenever he gets a 
fresh cold. The disease begins with difficult deglutition, 
pain, heat and dryness in the throat, and always more or 
less fever, from which some children become quite delirious. 
The affected tonsils become as large as pigeon eggs, and 
can be readily felt beneath the angle of the lower jaw. The 
swollen tonsils are red and dotted with yellowish spots, 
which is due to the suppuration of the follicles of w r hich the 
gland is composed. If both swell at the same time so that 
they touch each other, symptoms of suffocation may ensue. 
The writer suffered from tonsilitis when he was a student, 
and the pain was indeed excruciating for a time. The pain 
is sometimes greater in swallowing fluids than solids. In 
examining the mouth a little skill is required. Some chil- 
dren are so well trained that they will respond at once, and 
then by means of a spoon handle the tongue is depressed, 
and the tonsils come into view. Others again have their own 
sweet will about these things, and simply will not voluntarily 
open their mouths. Then it takes two persons to manage 
them in the following manner: while one person holds the 
child in his lap, its back and head braced against his chest 
and the hands held down, the other person slides the handle 
of a teaspoon along the tongue until he touches the soft palate; 
this makes the child gag, and at that moment the tonsils are 
brought plainly into view. 

The treatment for tonsilitis should be prompt and active ; 
that is, when the disease is recognized, something should be 
done at once to relieve it. If the bowels are constipated 
give a laxative at once, and over the painful tonsils apply a 
flaxseed poultice, keeping the neck and head wrapped up 
w r ell at the same time. For the fever give a dose of antifebrine 



346 HOME TREATMENT. 

in the forenoon and at bedtime; for a child one year old, one 
grain for a dose ; at the age of three or four, give two grains 
at once, and at eight to twelve years, three grains can be 
given. Chlorate of potassa is the best remedy for a gargle, 
and for internal use also. Make a solution of chlorate of 
potassa by dissolving one teaspoonful in a teacupful of hot 
water, and when cooled off, have the child gargle every hour 
or two, and swallow a half to a teaspoonful of the solution 
at the same time. 

(/) Diphtheria of the throat is eminently an epidemic 
disease and of a highly contagious and infectious nature. 
Of late years, the disease occurs in every season of the year, 
and independently of any epidemic or contagious influence, 
but it is presumed that the contagion or spores are cultivated 
in improper sanitary conditions arising from defective sew- 
erage and filthy accumulations. The disease invariably be- 
gins with fever, a marked increase of the pulse, increase of 
the temperature of the skin, and general depression. There 
is first a difficulty of swallowing, a snuffling voice and stiff- 
ness in the neck; the first two signs are due to the swelling 
and diphtheritic coating of the tonsils, palate and nasal 
passages, while the last symptom is due to a swelling of the 
lymphatic glands of the neck which is never absent in gen- 
uine diphtheria. If the throat is examined in the early 
stage, the white membrane is first seen in the tonsils and as 
the disease progresses it spreads to the palate, the pharynx 
and the nasal passages. The color of the membrane also 
changes; after several days it passes into a yellowish-white 
or grayish -white tint. It has another peculiar feature that 
distinguishes this membrane from the exudation of ordinary 
tonsilitis, which the practical eye at once detects; the mem- 
brane of diphtheria makes the impression of having eaten 
into the tonsil or as though it was pressed into the tissue by 
the finger. And that is really so too, because as a scientific 
fact it is no membrane at all, but a death or slough of the 
mucous membrane which mav extend down into the tissue 



DISEASES OF CHILDREN. 34 i 

beneath the membrane. To treat diphtheria successfully 
is simple enough but it requires great skill and experience, 
and I will outline what I consider the proper thing to do 
and which in my hands saved those lives that were intrusted 
to my care. 

The treatment resolves itself into perfect cleanliness or 
disinfection, stimulating nourishment and internal medica- 
tion. 

Everything must be kept clean around the patient, and a 
vessel must be provided, containing a little chloride of lime 
into which he spits or hawks the phlegm from his throat. 
The membrane or slough in the throat or nose must be thor- 
oughly disinfected and the only evidence that this has been 
successfully accomplished is when all offensive odor has dis- 
appeared. For this purpose as a local application I employ 
the following preparation: Solution of subsulphate of iron 
(Monsel's solution) 3 drams, glycerine 5 drams; mix and 
pour ten to twenty drops into a saucer and by means of a 
camel's hair brush apply to the diphtheritic membrane un- 
til the character and odor of it is destroyed; this application 
repeat every four hours. Should the nasal passages be also 
affected mix a teaspoonful of the preparation to a tea- 
cupful of warm water and by means of a syringe wash the 
nasal passages out several times a day. Give the patient 
internal medicine to disinfect the stomach and for its alter- 
ative action on the blood: for this purpose use tincture of 
iron 4 drams, simple syrup, add to make 4 ounces. To a 
child seven to ten years old give a teaspoonful, ten or fifteen 
minutes each time, after the brushing. Between the times 
of brushing and giving the medicine, that is two hours 
afterwards, give the nourishment and stimulant; this consists 
of milk punch. A child seven to ten years old should take 
no less than a tablespoonful of whisky, with or without a lit- 
tle sugar, in a half to a teacupful of milk beaten thoroughly 
together with an egg beater; this is to be taken for a meal and 
drank at once, and repeated every four hours. No other 



348 HOME TREATMENT. 

food or nourishment must be given for a number of days, 
and if the child is thirsty between times allow it to drink 
sweetened water and whisky. Sometimes the glands of the 
neck and the tonsils swell and become very painful ; for this 
the Belladonna ointment applied with gentle friction night 
and morning and the neck enveloped in cotton batting are 
certain to give relief. The efficiency of this treatment de- 
pends upon the intelligence and faithfulness with which it 
is used. 

(g) Croup is a term derived from the German Kropf 
the crop or craw of the bird; this disease is known by a 
great many different names, but on account of its shortness, 
croup has received the preference. The disease has to do 
with an affection of the organ of the voice, the larynx, which 
is the upper part of the air passage, and situated between 
the trachea and base of the tongue at the upper and front 
part of the neck where it forms a projection in the middle 
line which is prominent above and called the pomum 
Adami or Adam's apple. The larynx contains the vocal 
cords, running from before backwards on both sides; these 
form the narrow fissure or chink, the rima glottidis, through 
which we breathe. Like all other air passages this too is 
lined with mucous membrane. The symptoms that fore- 
shadow croup are not particularly significant, for they sim- 
ply indicate that the child has a cold. The children have 
a cough, they sneeze, and their appetite is capricious for a 
few days; they are not as lively as usual and are more or 
less feverish. In a certain proportion of cases there is 
nothing noticeable before the croup develops, for the chil- 
dren may go to bed perfectly well and sleep calmly the first 
few hours of the night, when suddenly they are awakened 
with a barking cough, which greatly frightens young chil- 
dren and they begin to cry. The cough may repeat itself 
at short intervals, the voice become hoarse and husky and 
lower and lower, so that in the morning a well marked 
croup is developed. The voice finally disappears so com- 



DISEASES OF CHILDREN. 349 

pletely that it is not heard above a whisper, and the greatest 
pain and harassing symptoms of suffocation do not enable 
the child to utter a loud sound. The respiration becomes 
labored in proportion to the swelling of the vocal cords and 
other obstructions to the passage of air through the larynx. 
Croup has vagaries that cannot be foretold. One child may 
have symptoms of so threatening a nature that one believes 
it will suffocate at any moment, yet, with a few simple rem- 
edies, the symptoms will gradually lessen and it recovers in 
a few days, while another may be suffering comparatively 
little and from appearances one would imagine that there is 
little or no danger, but at once it will change and grow 
worse so rapidly that it will die in a few hours. For this 
simple reason no case of croup should be carelessly or lightly 
considered. When a child has croup it should be put at 
once into a warm room ; a big fire should be kept up, and 
the child given hot drinks or a cupful of hot tea so as to 
make it sweat. The front part of the neck should be rubbed 
with equal parts of turpentine and sweet oil until it feels 
warm and the skin reddens. If the child has eaten a good 
supper, a teaspoonful of syrup of ipecac should be given 
every half hour until it vomits; otherwise vomiting should be 
omitted. The following mixture always gives relief and 
with other precautions is all that is usually required. 

Take: Bicarbonate of potassa , 2 drams 

Water 1 ounce 

Hive syrup, 

Paregoric, of each J ounce 

Mix and give half to one teaspoonful every two hours 
until relieved ; then every four to six hours. 

What we have considered thus far is also called spasmodic, 
catarrhal or false croup, to distinguish it from another variety 
that is described under the name of membranous or diph- 
theritic croup. 

This form of croup as its name indicates is characterized 
by a membrane which forms upon the surface of the in- 



350 HOME TREATMENT. 

flamed mucous membrane of the larynx as an exudation, 
and sometimes the croupous membrane extends down into 
the windpipe or trachea. 

This variety of croup begins just like the simple or 
catarrhal form only as the disease progresses the symptoms 
gradually grow worse, and remain persistent. It is fortunately 
a very rare disease and almost always fatal when it does 
occur. An ordinary or catarrhal croup may, when neglected, 
run into the membranous form and for that reason children 
who are croupous, no matter how light it may appear, should 
be carefully nursed until the symptoms have passed off. 
The treatment for membranous croup has been on the whole 
very unsatisfactory; the membrane which forms in the 
larynx and windpipe is the cause of suffocating the child, 
and the question how to remove this has never as yet been 
answered. Of course a great many remedies have been 
suggested and used but at times all have disappointed. The 
successful case of membranous croup that I treated many 
years ago was cured by giving the little patient inhalations 
of lime water with a steam atomizer and besides giving 
whisky and milk as nourishment; 'how much of the success 
in this case was due to the child's vigorous constitution and 
how much to the treatment will always remain a mystery. 
In the commencement, the same treatment that was recom- 
mended for false croup is advisable; later on the skill of a 
good physician is required. 

(h) Bronchitis or catarrh of the bronchial tubes is gen- 
erally the cause of the ordinary cough due to exposure or 
taking cold. Its danger depends upon the severity of the 
bronchial inflammation and upon the age of the patient; 
the younger the child the more dangerous the disease. In 
older children or adults there is no connection between a 
bronchitis and a pneumonia, but in infants or children un- 
der two years of age who are suffering from bronchitis the 
tendency toward a complication with pneumonia is ever 
present ; in fact, in children of this age, pneumonia usually 
begins in that way. 



DISEASES OF CHILDREN. 351 

Cough is the most prominent symptom and it is always 
present from the commencement of the affection, and appre- 
hensive of this the parents seek medical assistance. The 
expectoration in young children is generally swallowed after 
each paroxysm of cough, hence the nature of it can rarely 
be seen. In the first part of the night the cough is always 
more severe than during the day, and the paroxysms may 
last from half to one minute, recurring several times in the 
hour. Some children are less disturbed in their sleep than 
others, for they sleep on, notwithstanding the cough, while 
others always awaken, become annoyed from the disturbance 
and cry. These interruptions in their night's rest reduce 
them in strength and flesh. Children who cough more 
when laid on one or the other side than when they lie on 
their back and who distort their face when coughing or, when 
old enough, complain of pain during or after coughing have 
something more than a simple bronchitis ; they have a com- 
plication of pleurisy or a pneumonia. There is always fever 
and this may run very high, so that the child becomes delir- 
ious; even before the fever becomes very pronounced or the 
cough very annoying, their little hands and faces feel hot to 
the touch, indicating that they are not well. 

Infants require good nursing when they are suffering 
from bronchitis, and it is not good to let them lie on their 
backs all of the time; when they have a coughing spell take 
them up quickly and lay them across the knees, with their 
faces downwards; this gives the mucus a chance to run out 
of the bronchial tubes and mouth which is better than 
swallowing it. The most important feature in the treatment 
of bronchitis is a warm room of even temperature night and 
day. If the temperature is allowed to go down during the 
night and the child inhales cold air into the lungs it will 
often bring on a relapse or aggravate the disease. When 
children have a cough and cold they must be kept warm in 
order to get w T ell ; this is no time for trying to harden them. 
A thermometer should be in every house and certainly in 



352 HOME TREATMENT. 

every bedchamber, so that the temperature of a room may 
be gauged to a certainty. In ordinary cases the temperature 
should not fall below seventy degrees Fahrenheit, and when 
the child coughs very much and the bronchitis is very bad 
it is best to keep the temperature of the room around eighty 
degrees night and day for several days, and as the patient im- 
proves, it is advisable to gradually drop to seventy. 

The application of oil and spirits of turpentine is advisa- 
ble in all cases of cold in the chest ; it does good and one 
can hardly explain how and why. For the cough an infant 
can take with great advantage three or four drops of syrup 
of ipecac together with the same amount of paregoric, 
every four hours; older children take larger doses in propor- 
tion. When scrofula or tuberculosis is at the bottom of the 
bronchitis, a reliable preparation of cod liver oil emulsion 
should also be administered. 

(i) Pneumonia is the technical term for inflammation of 
the lungs or lung fever. It consists of an inflammation, 
involving the air cells and smallest air tubules of the lungs; 
in other words, it is an inflammation of the substance or 
tissues of the lungs. 

It is altogether a more serious affection than bronchitis, 
and in very small children exceedingly dangerous. The 
inflammation may affect either a small circumscribed por- 
tion of the lung, lobular pneumonia, or it may compromise 
an entire lobe or all the lobes of the lung, and is then 
called lobar pneumonia. Pneumonia is dangerous in propor- 
tion to the extent of lung tissue involved and the symptoms 
become correspondingly aggravated. The disease occurs 
extremely often in children, but it is altogether different 
from that which occurs in the adult. In children it is of a 
bronchial nature, that is, the ordinary bronchial catarrh 
has a tendency to extend to the very small bronchial tubes 
(capillary bronchitis), thence into the air cells of the lungs. 
In this variety of pneumonia the lungs do not become in- 
flamed in their entirety, but here and there patches of lung 



DISEASES OF CHILDREN. 353 

tissue become the seat of lobular pneumonia. In the nurs- 
ling, catarrhal pneumonia is an extremely frequent affection 
and I believe that it is principally due to the carelessness 
and promiscuous bathing of infants to which I have already 
referred. In foundling hospitals this disease destroys a great 
many children, and the chief cause has been attributed to 
their lying both night and day in a horizontal posture. 

It has been statistically proven that many more children 
suffer from the disease in winter than in summer, and 
further, that in those parts of the lung that are inflamed the 
bronchial tubes which lead to them are also found to be in- 
flamed. This relation of catarrhal pneumonia to bronchitis 
may be accounted for by the play of a mechanical force and 
thus illustrates the relation of cause and effect. The secretion 
of bronchitis not being expectorated, gravitates into the 
region in which the inflamed bronchial tubes terminate, 
namely, the air cells of the lungs, and by irritating and block- 
ing or filling the air cells, a catarrhal pneumonia is devel- 
oped. 

The symptoms of pneumonia in children under two years 
of age are those of the catarrhal or lobular type; after they 
have passed through their first dentition they become subject 
to lobar pneumonia which differs in no particular from the 
disease which occurs in grown persons. Practice and experi- 
ence make the discovery of catarrhal pneumonia possible in 
little children as soon as they are under observation for a 
little while. The most prominent sign is the rapidity of the 
respiration, which rises to sixty and eighty per minute in- 
stead of forty-four, the average normal respiration for the 
first year of infantile life. 

The disease begins with a cough and more or less fever, 
and as it is always preceded with bronchitis, the symptoms 
that were enumerated when speaking of the latter disease are 
equally applicable to this one. Later on, when the transi- 
tion of bronchial catarrh into pneumonia takes place, all the 
symptoms become at once aggravated. The breathing, for 
23 



354 HOME TREATMENT. 

instance, becomes labored and increases and the nostrils 
dilate with each inspiration. The mouth is open, and its 
comers are drawn downward and outward, depicting dis- 
tress and suffering, while the eyes roll anxiously about or 
become glassy and staring. 

The treatment of pneumonia in its early stages would be 
the treatment of bronchitis, since every pneumonia in young 
children is preceded by a bronchial catarrh. The uniform 
temperature is of the first importance. The same remedy 
that was suggested for the cough in bronchitis is also here 
serviceable. 

A systematic course of nourishment must form a part of 
every successful treatment for pneumonia; and as an old 
medical friend once told me in a consultation "if the child is 
kept alive long enough with nourishment it is bound to get well. " 
In critical cases it is surprising the large amount of whisky 
a little infant consumes with avidity; its eyes begging and 
watchingly following the teaspoon from the cup to its mouth. 
I attended my own child once when only three months old and 
although there seemed no hope, for its tiny finger tips were 
blue and its lips livid from deficient aeration, yet it eagerly 
took its teaspoonful of whisky toddy every fifteen minutes 
through the longest part of the night, and towards morning 
it took a change for the better and its life was saved. I also 
believe that these babies must be kept in a constant sweat; 
this relieves the congestion of the lungs. The nourishment 
must be given at regular intervals of several hours just as 
you would give medicine, for indeed it is a medicine at this 
time. 

Another valuable agent to which I attribute a number of 
recoveries is the application of a moist girdle suggested by 
Professor Alfred Vogel, of the University of Dorpat, Russia. 
In his work on "Diseases of Children" he says: "A diaper, or 
large white pocket handkerchief is folded up like a cravat; the 
bandage thus obtained should be three or four fingers wide, 
and the whole length of the handkerchief. This is now 



DISEASES OF CHILDREN. 355 

dipped in warm water, and wrung out so that the cloth docs 
not drip, and then applied like a girdle around the chest of 
the child. A second cloth, double the size of the first, is 
folded up in the same manner like it, but which must be six 
to eight fingers broad, and then applied dry and warm over 
the first. It is very advisable to interpose a piece of gutta 
percha or oil silk between the dry and the wet girdle by 
which on the one hand, the moistness of the first cloth is 
preserved longer, while on the other, the second does not 
become wet. If the water with which the fomentations are 
made is not too cold, the child will tolerate them very well 
and in a short time, a slight retardation in frequency and 
improvement of the respiration are indicated by less motion 
■of the nostrils. These warm compresses should be continued 
for from four to six days, and it is not at all necessary, dur- 
ing the entire time, to remove the bandage; the oil silk is 
raised up a little, and a few teaspoonfuls of water are poured 
upon the girdle or it is moistened with a sponge. The prin- 
cipal thing is not to allow a cooling of the skin by evapora- 
tion to take place. To secure this object, the dry cloth 
should properly overlap the moist one on all sides and as it 
is impossible to prevent the upper cloth from becoming wet, 
it should be changed several times during the day. I cer- 
tainly have applied this girdle many hundreds of times, and 
have very often seen rapid improvement ensue; neverthe- 
less, it cannot be denied that the half of these children per- 
ish notwithstanding. If cold compresses are applied the 
children cry of fright in consequence, and the symptoms be- 
come worse until the cold water has become warm." The 
application of blisters, cupping or leeching should not be 
tolerated. 



CHAPTER XXX. 

DISEASES PECULIAR TO CHILDREN— Continued. 

(a) Indigestion in very young children is generally 
accompanied with diarrhoea, because that portion of the 
child's food which is not thrown up or digested passes along 
the intestinal canal and acting as an irritant causes diarrhoea. 
An indigestion of only a short period of duration excites a 
catarrhal inflammation of the mucous membrane of the 
stomach, and this may be so slight that even a change or 
correction in the diet may be all that is required to relieve 
it. Children who are suffering from indigestion have stom- 
ach ache; this may be continuous or come on half an hour 
or an hour after nursing. The pain is due to the irritation 
caused by the nutriment or to the fermentation of the food 
and the consequent accumulation of gas within the stomach. 
The stomach becomes distended and sensitive to pressure. 
When the catarrh is severe the nutriment that the child 
takes into the stomach is immediately rejected or it may 
vomit glairy or greenish mucus from an empty stomach. 
At first the nutrition of the child may not be greatly inter- 
fered with, for some of the food is retained and digested in 
the small intestines, but in the course of time these too be- 
come irritated and then diarrhoea complicates the case and 
the child falls off and becomes rapidly emaciated. Children 
who are nourished from their mother's breasts rarely suffer 
from indigestion, but those who are fed on artificial foods 
become victims of stomach and bowel troubles. And for 
this reason it is natural to suppose that the chief reliance for 
a successful treatment is to regulate and study the diet of the 

( 356 ) 



DISEASES OF CHILDREN. 357 

sufferer; the chapter that is especially devoted to this sub- 
ject should be consulted for further information. 

(b) Diarrhoea is a derangement of the stools in which 
they loose their semi-solid, pap-like consistence and become 
watery liquid alone, or watery liquid in which indigested 
particles of food and fecal matter remain suspended. The 
quantity of alvine matter that is evacuated greatly exceeds 
that which passes in the normal state. The stools have an 
alkaline or acrid nature which irritates and often inflames 
the anus and the surrounding integument. "The normal 
form of the infantile feces in the first year of life is the 
pappy; the color is yellow like that of the yolk of egg; the 
smell is feebly acid, never putrid, and only in children who 
are fed upon a meat diet as repulsively pungent as in the 
adult; in later years they are no longer distinguished from 
the adult." 

The passages of diarrhoea may be simply softer, but yel- 
lowish and increased in quantity, or they may be bright 
yellow and so watery as to squeeze out from the anus as 
from a syringe and soak through diapers and bedclothes, 
or the stools may be green, or bilious, and slimy. When 
children teethe they often have a diarrhoea for several days; 
this intestinal derangement has no connection with improper 
feeding, yet it requires to be watched lest it become serious 
and uncontrollable. There is still another kind of diarrhoea 
which is foamy and contains large quantities of mucus and 
little or no coloring matter. For the different varieties one 
and the same remedy will answer, and that which I here 
submit has never disappointed my expectation: — 

Take : Subnitrate of Bismuth 1 dram 

Powdered Kino 16 grains 

Rubbed thoroughly with 

Glycerine 1 dram 

Paregoric , 2 drams 

Chalk Mixture, sufficient to make 2 ounces 

Shake the mixture thoroughly before using, and the 



358 HOME TREATMENT. 

dose can be regulated between ten drops for an infant to a~ 
teaspoonful for a child three or four years old. 

(c) Dysentery or Flux is an inflammation of the mu- 
cous membrane of the large intestine, or colon, extending 
down to the rectum. Children under one }^ear of age are 
not as liable to this affection as those who are older, and it- 
is during their first dentition that the affection shows itself. 
In hot summer months, at the season of unripe fruits, the 
disease often becomes epidemic. The loss of strength and 
flesh is very rapid, and when children do not perish during 
the first few days of their sickness, they may succumb later 
when the disease has assumed a chronic form. Dysentery 
is extremely liable to become complicated with pneumonia, 
anaemia, pyaemia, perforations and strictures of the intes- 
tines, jaundice and abscess of the liver, and in proportion 
that these complications become developed life becomes seri- 
ously threatened. The symptoms of dysentery are striking 
and can hardly be mistaken for anything else. There is 
always pain over the abdomen, but on touching the abdomen 
near the navel and over the course of the colon the pain is 
greater than elsewhere. 

Tenesmus is a characteristic symptom of dysentery. 
This is a straining sensation as if the bowels wanted to 
move, yet notwithstanding the violent bearing down, only 
a little mucus often streaked with pus or blood is discharged. 
The straining causes the lower folds of the rectum to protrude,, 
and this portion of the bowel presents a livid red color; the 
sufferer is tormented a great deal by this fruitless bearing 
down, and the bowels should be anointed with pure zinc 
ointment and returned. The stools of the child are charac- 
teristic of this disease. Every passage' contains glairy mu- 
cus formed into lumps resembling granules of boiled starch, 
streaked with blood and associated with a creamy looking 
substance which is purulent matter. If the disease has 
progressed to the formation of ulcers the evacuations be- 
come grayish red or assume a dirty ashen color, and the 



DISEASES OF CHILDREN. 359 

odor is putrescent. Portions of the mucous membrane 
slough off and large quantities of pus are discharged from 
the ulcerating surfaces so that the stools present sometimes 
nothing but purulent and bloody matter. 

The treatment for this disease must be prompt and di- 
rected to the point; reliance must not be placed upon one 
single remedy, but a combination of expedients must be re- 
sorted to. 

The greatest annoyance and source of pain is the strain- 
ing and tenesmus, and to relieve this steps must at once be 
taken. There is hardly any use to give injections for this 
purpose for the irritable condition of the rectum makes it 
impossible for the child to retain them long enough to do 
any good. Use suppositories instead, and if need be, retain 
them by holding a soft compress of cloth over the anus, for 
ten to fifteen minutes until they are dissolved. For example, 
to a child one year old I employ the following suppository: — 

Take: Laudanum 1 drop 

Cocaine ^V grain 

Bismuth Subnitrate 10 grains 

Cocoa Butter 10 grains 

Make into one long suppositoiy and roll in powdered bis- 
muth, dip it first into oil or vaseline and insert into the rec- 
tum every three or four hours until the soreness and straining 
have subsided. • If the child is not very sensitive nor very 
ill an injection of a teaspoonful of boiled liquid starch to 
wTiich a few drops of laudanum have been added, may be 
used instead and as often as may be necessary. Cold drinks 
aggravate the pains, therefore give everything warm. 

Cow's milk should be dispensed with in artificially fed 
children, and broths substituted to which a portion of a fresh 
egg is added, previously thoroughly beaten w T ith an egg beater ; 
in very young children the yolk alone should be used. A little 
whisky is always good for this class of patients, either in 
their broth, or given as a toddy in teaspoonful doses for the 
children are generally always thirsty and feverish. When 



360 HOME TREATMENT. 

children lose their appetites and refuse nourishment they 
must be coaxed and even forced to take food at regular 
intervals, otherwise they cannot rally and will perish from 
inanition. The medicine that I recommended for diarrhoea 
is also very useful for dysentery. 

(d) Colic is the result of an abnormal accumulation of 
gas, flatulency, in the small intestine. There is always more 
or less gas in both stomach and bowels, but usually this 
passes off and there is no pain felt from it. It is when the 
quantity increases so as to distend the bowels that the walls 
of the intestines become the seat of pain. The pain comes 
on in paroxysms, or fits at short intervals, and increasing in 
violence. Children suffering from colic have the abdomen 
swollen or bloated, giving rise to that condition termed 
meteorismus or tympanites. Those who are under one year 
old are the most liable to colicky pains, for it is during this 
period of life that digestive disturbances are the most 
frequent, and these constitute the chief cause. Whenever 
the vermicular motion of the intestines becomes lessened or 
suspended, the gas is not expelled from the anus, and the 
accumulation causes the characteristic pains under consid- 
eration. In perfectly healthy digestion there is always more 
or less gas developed, and even then there may be colicky 
pains. The same pains originate with every diarrhoea that 
is due to improper food or feeding, and in dysentery too they 
are generally present. Infants who nurse at their mother's 
breasts are less liable, but not altogether exempt, for moth- 
ers' milk is very sensitive to impressions of purely physical 
exertions, or to emotions of fear or fright, thus her milk may 
become unhealthy for her child; or through her own diges- 
tion, suffering from temporary or permanent derangement, 
her milk may transmit a similar condition to her child; the 
mother may have eaten green fruit, or too much of a variety, 
or it may be too highly seasoned, or too fatty. Many moth- 
ers and nurses look upon the colic cry as a hunger cry, and 
hasten to feed the little one, and sometimes a few teaspoon- 






DISEASES OF CHILDREN. 301 

fuls of milk or broth will relieve the cry for a few minutes, 
then the pain returns severer than ever, and the baby cries 
louder than ever. I have seen very nervous children thrown 
into convulsions from severe colicky pains. 

My rule has been for years to nurse infants for the first 
two months not oftener than once in two hours; after that 
until they are six months old, every three hours, and from 
six to twelve months every four hours; between times the 
babies cry, of course, not because they are hungry, but 
because they have either pain or are thirsty. The old Ger- 
man household remedy for this is fennel seed tea; there is noth- 
ing as useful; it expels the gas and it quenches the thirst 
from which colicky children suffer, at least while they have 
the colic. This tea should be given regularly between 
times, and until they are twelve or fifteen months old ; it is 
soothing, and what is of equal importance, it prevents over- 
feeding, which is the bane of artificially-fed children. The 
latter, bottle-fed babies, are all more or less colicky, and for 
these the fennel seed tea, between bottle time is indeed a balm. 
If the fennel seed tea does not relieve the child at once, or if 
the pain seems severe, then add a few drops of paregoric to 
the fennel seed tea, and give an injection of German chamo- 
mile tea, rubbing the bowels at the same time with a mixture 
of turpentine and sweet oil, and I believe that every case 
will be relieved. Permanent relief must be sought in ferret- 
ing out the cause and removing it. This may be due to 
improper food, or feeding, to indigestible contents in the 
stomach or bowels, and indeed, very often to constipation. 
When the stomach is overloaded, a dose of syrup of ipecac 
may give relief, and if due to constipation, the Femina 
laxative syrup is the most appropriate remedy. 

(e) Convulsions, or spasms in children have long been 
well known to the laity, and from their frequent occurrence 
they make an important class of children's diseases. If 
there is one thing more frightful to behold than another, to 
the young and inexperienced mother, it is to see her baby's 



362 HOME TREATMENT. 

eyes unsteadily rolling, or turned up so as to show only the 
white of the eyeballs, or may be the eyes steadily fixed in 
a stare while the child becomes completely unconscious. A 
painful smile may play over its face, or an expression of 
fear or anger may distort the facial expression, while the 
muscles of the face twitch convulsively. The jaws are 
sometimes set, then again there is gnashing of the teeth, 
alternating with relaxation of muscles and ligaments. The 
child cannot swallow, and fluids poured into the mouth flow 
out again. The other muscles of the body also participate in 
the spasmodic contractions ; those of the back contract and 
relax, and those of the extremities are involved in lively 
twitchings, or perform acts of thrashing, striking or twist- 
ing. The breathing becomes very irregular, and from the 
spasms of the muscles of the larynx or throat it may 
become entirely suspended, and if the spasm does not sub- 
side in two or three minutes the child may die. The skin 
becomes livid or congested and loses its sensibility so that 
blisters or irritants make no painful impression. Some- 
times the child bleeds from the nose or mouth ; the latter is 
generally due to the tongue having been caught between 
the teeth during the paroxysm. Frothy saliva wells up 
from the mouth and the urine and stools are involuntarily 
discharged. 

All convulsive attacks have not every symptom above 
enumerated, some of them are usually absent and an attack 
may be quite mild, and last only a few moments; if convul- 
sions last longer they are not only dangerous, but indicate 
serious disease, either of the brain or in which the brain or 
spinal cord is seriously complicated. 

The period of the child's life at which convulsions are 
most frequent is from the time they are born up to the com- 
pletion of the first dentition. Nervous children who had 
convulsions while they were teething are susceptible to vio- 
lent attacks at the commencement of various diseases or 
during the developmental stage of the eruptive fevers. Per- 



DISEASES OF CHILDEEN. •><>'■> 

haps the most frequent cause of convulsions in children is 

the eruption of teeth. The irritation which a growing tooth 
causes in the gums also irritates its nerve and this irritability 
is reflected on the brain, and this causes the spasm. An 
overloaded stomach, worms and digestive disturbances that 
accompany teething irritate the bowels and from this too 
convulsions ensue. The treatment for convulsions naturally 
resolves itself into first giving instant relief during the par- 
oxysm, and secondly, finding out the cause of the attack. 
The latter is not always easy at first sight, and as the cause 
may be serious a competent physician should be sent for. 
But instructions that are serviceable while the convulsion is 
on are of the greatest importance to mother and child. The 
old and familiar remedy of giving the child a hot bath as 
soon as possible is certainly the best thing that can be done. 
The child should be undressed as quickly as possible so as 
to relieve it from all constriction and so that nothing can in- 
terfere with the respiration and circulation. 

A towel wrung out of cold water should be placed over 
the child's head and its body immersed in hot water that is 
not so hot as to scald; the hands on which the child is sup- 
ported while in the water must be well able to stand the 
heat. AVhen the spasm has subsided, the child should be 
transferred to a previously warmed woolen blanket in which 
it is to be wrapped with its head softly elevated. If the 
bowels are constipated an enema of warm water and a little 
castile soap should be administered. 

(f) Worms of different species infest the human organ- 
ism; they get into the system from the outside world, with 
the food we eat and drink. Their abiding place seems to be 
the mucous membrane of the intestinal canal with the ex- 
ception of the trichinae which penetrate the mucous mem- 
brane and make their way to the different muscles throughout 
the body; the voluntas muscles seem to be their permanent 
dwelling place. These parasites are peculiar to the meat of 
the hog and as very young children do not eat this meat, 
they are so far totally exempt from them. 



364 HOME TREATMENT. 

Tapeworms are rarely found in children under one 
year of age; it is when they get older and especially when 
they eat hog's meat, for this too is the home of the embryo 
tapeworm, that they become infected. 

The roundworm, however, is peculiar to childhood. It 
is a yellowish or whitish worm resembling the earthworm, 
from one to twelve inches in length. The body is round, 
tapering toward each extremity. This worm inhabits the 
small intestine, but by acts of vomiting they are frequently 
ejected from the mouth or they may find their way into 
other cavities. On the Pacific slope these worms are not as 
frequently met with as on the other side of the Rockies. It 
is propagated by ova and taken into the system by means of 
drinking water containing them. The number varies greatly 
in different cases; sometimes there are only a few and again 
there may be dozens or hundreds coiled together so as to 
form balls or masses. They are most common between the 
ages of three and ten years. I do not believe that they ever 
exist in early infancy. 

The symptoms denoting the presence of these parasites 
are on the whole obscure and depend somewhat on the tem- 
perament of the individual. A nervous child may be thrown 
into fits or convulsions from them. My first case of these 
worms in a child seven years old was rather exceptional and 
remarkable. The child was suddenly taken with a severe 
attack of spasmodic croup, for which I prescribed remedies 
without much relief. After the second day the child passed 
five large roundworms, the croup subsided, and while I 
claimed no credit that my remedies did not cure the croup 
it was generally conceded that they killed the worms. 

The usual symptoms are colic pains, impaired appetite, 
diarrhoea, itching of the nose, swollen abdomen, puffy fea- 
tures, offensive odor of breath, dreaming sleep and grinding 
the teeth during sleep or twitching of the muscles. 

The expulsion of the parasite is generally effected with 
simple remedies. Five to ten drops of spirits of turpentine 



DISEASES OF CHILDREN. 305 

in half to one tablespoonful of castor oil is a reliable remedy. 
The oil of wormseed is another convenient remedy in the 
same dose on a lump of sugar or mixed with oil; a cupful of 
tansy tea early three or four mornings on an empty stomach 
serves a useful purpose; pinkroot and senna administered as 
a tea has also a well-deserved popularity. 

The thread, pin, spring or mawworm inhabits the large 
intestine and chiefly the rectum. It is a thin yellowish- 
white parasite from one-twelfth to one-third inch in length; 
the female has a straight, awl-like, pointed tail, the male has 
a strongly curved tail. It rarely, if ever, enters the small 
intestines. The worms occur chiefly in young children, but 
there is no period of life that is exempt from them. They 
cause pain and an itching sensation at the anus. This is 
particularly troublesome when the children lie in warm beds. 
The sexual organs are apt to become excited from the irrita- 
tion and the habit of masturbation be thus formed. In girls 
the worms may travel into the vagina and leucorrhcea in 
children is often accounted for in this way; around the anus 
there may be pimply redness. 

From the loss of appetite and sleep the general health of 
the child may become impaired; but the only possible evi- 
dence of the presence of worms is to examine the stools. If 
worms of the above description cannot be seen, yet the symp- 
toms make their existence suspected, a dose of some of the 
remedies above suggested should be given and afterwards 
the stools again examined. Some children have a peculiar 
predisposition to pinworms, and although you seem to give 
them relief for the time being, in a short time afterwards the 
same symptoms return and the worms are as numerous as 
ever. In these cases a course of continual treatment becomes 
necessary to eradicate the morbid habit; for this course I 
recommend : 

Take: Powdered wormseed, 
Powdered chocolate, 
Milk of sulphur, of each equal parts. 



366 HOME TREATMENT. 

Mix and give half to one teaspoonful every night at bed- 
time. 

(g) Constipation is the bane of artificially reared children 
and if the sagacity of mother or nurse does not correct the 
evil it often causes serious complications. Sometimes those 
who are nursed on the breast suffer from constipation, espe- 
cially when the mothers or wet nurses are troubled with sim- 
ilar derangements Children under one year of age should 
have two evacuations, and those from one to three years 
should have at least one passage a day; when this does not 
occur the feces become solid and constipation is the result. 
In most febrile affections constipation is caused by a loss of 
moisture through the skin and an increased urinary secre- 
tion. Certain foods constipate, especially the starchy or 
farinaceous variety, as soups containing corn starch, rice, 
sago, etc., and in older children certain dishes consisting of 
peas, beans, and wheaten bread. A great many medicines 
are constipating, for instance, most cough mixtures, for they 
contain opium in some form, also preparations of iron, lead, 
alum, bismuth, chalk, and vegetable remedies that contain 
astringents or tannin. 

It must be laid down as a rule never to be violated, 
that every child must have at least one passage a day from 
the day it is born, and it is the imperative duty of mother 
or nurse to see that it is accomplished. The infant of only 
a few days or weeks old may require only a few drops of 
olive oil, but if that delays in its effect it may become neces- 
sary to give relief at once, and for this purpose we have in 
a small warm water enema a most decided and effectual 
remedy. Soapsuds should never be used, except in very 
urgent cases, for I have known a diarrhoea to ensue from the 
irritation it caused which was very hard to control. If the 
feces are not very hard a soap suppository may be used with 
good advantage, and in the following manner: Take a piece 
of soap and pare it to a point the thickness of a lead 
pencil and about an inch long, moisten this and introduce 



DISEASES OF CHILDREN. 367 

carefully into the rectum; if the straining bring only the 
soap away it may be well to use the water enema afterward. 
If the constipation continues to be habitual a slight modifi- 
cation of the diet becomes necessary; starchy foods must 
not be given as often, and thinner than formerly; the milk 
too should be more diluted; broth or beef tea substituted 
once or twice eacli day will often have a good effect. When 
children are old enough to eat mixed food the diet can often 
be so regulated as to materially contribute towards opening 
the bowels. The children should be encouraged to drink a 
great deal of water; from the lack of that alone some chil- 
dren become constipated. Graham bread and boiled Ger- 
man prunes are especially to be recommended; so are ripe 
raw fruits, grapes, strawberries, apples, pears, etc. Children 
require fresh air and outdoor exercise to be well and robust; 
they run and jump more when in the open air, all of which 
gives tone and strength to the general system. If diet and 
outdoor exercise alone does not remedy the evil, then the 
Femina laxative syrup should be administered; it is effi- 
cient in its action, and pleasant to take, and unlike most 
laxative or aperient remedies, there is no danger of forming 
a habit of using purgatives. 

(h) Whooping cough is the name of an affection deriv- 
ing its significance from a characteristic which is peculiar 
to this cough. It commences like an ordinary bronchitis 
such as is the result of taking cold; there is the usual hoarse- 
ness, tickling in the throat, dry cough, sneezing, running from 
the nose; the eyes are red and watery, and there is more or less 
fever. Sometimes the cough is ordinary, but at other times 
it has a sharp metallic clang from the beginning. Owing 
to certain marked periods in the course of the affection it 
has been found convenient to divide it into three stages 
which may usually be distinguished, although in a certain 
proportion of cases the first stage (comprising some of 
the symptoms that have been enumerated above) may be 
submerged into the second or whooping stage. The first 



368 HOME TREATMENT. 

stage may last from four to five days to as many weeks. 
The second stage is when the peculiar sound or whoop 
begins; it consists of a great number of violent paroxysms, 
rapidly-recurring spasmodic coughs, until most of the air in 
the lungs is expired; there is then a sense of suffocation and 
the child becomes bluish red over the entire head and face, 
from which the German designation blue cough has originated. 
During this spell the face swells and the eyeballs become 
congested and bulge from their orbits and the nose often be- 
gins to bleed, while the urine and feces are often involun- 
tarily ejected and the contents of the stomach thrown up 
from the violent contraction of the diaphragm. In a few 
moments the spell is broken by a protracted, whistling 
croupy inspiration, and this constitutes the whoop. 

The whooping generally grows worse the first two or 
three weeks, after which time in favorable cases the cough 
gradually becomes milder, but this is not the rule by any 
means. I have had it in my own family to last, in two in- 
stances, six months, and in another eight months before the 
children had fully recovered. 

Laughing or crying, swallowing dry, irritating morsels 
of food or cold and impure air will bring on a paroxysm of 
cough. When several children are affected together, the 
coughing of one will make the others cough. 

The third stage is when the cough is wearing off and has 
lost its severity. The expectoration consists now of a yel- 
lowish or green-colored mucus; in otherwise healthy chil- 
dren this lasts only a few weeks, but in weakly or scrofulous 
ones it may last for several months. This disease is not as yet 
thoroughly understood. It is an epidemic, contagious bron- 
chial catarrh, involving the nerves of respiration and at- 
tacks an individual but once. When complications arise the 
affection becomes exceedingly dangerous and the most com- 
mon of these is pneumonia. 

There is no specific cure for whooping cough; it has got 
to run its course, which may be either short or long. I have 



DISEASES 01 CHILDREN. 869 

tried every agent so far known to scientific medicine, and there 

is none that will give prompt relief in every instance. Whoop- 
ing cough being a bronchitis plus something else, it seems 
rational that the same precautions that are observed in a case 
of bronchitis should be followed here. Children with this 
affection must not be exposed to drafts or rough winds lest 
they get cold, which might seriously complicate matters. In 
summer when the weather is warm, out-door life is beneficial 
in hastening recovery. Some children have the cough so 
light, that no extra precautions seem to be necessary; they 
have no fever, eat, feel and sleep well. But those who are 
feverish, who vomit freely, and whose appetite is capricious, 
require every attention. Their diet should be especially 
guarded, so that all dry, irritating nutriments are prohibited, 
and so that the diet consists principally of liquid nourishment. 
Warm drinks have a favorable influence on the disease; a 
plentiful supply of warm milk, first thoroughly beaten with 
an egg beater is the most suitable and convenient. The milk 
punch is often borne well, and the little whisky that enters 
into its composition is a needed stimulant to the sufferer; 
broths may be given for a change, and to these the yolk of 
an egg can be added with advantage. A great many reme- 
dies might be suggested, but the one which has served my 
purpose the best, is the following : 

Take: Deodorized tincture, of opium J dram 

Fluid extract, of belladonna 4 drops 

Fluid extract, of ipecac 10 drops 

Simple syrup 2 ounces 

For a child five years old, give a teaspoonful three or 
four times a day; older or younger children in proportion. 
If the cough is hard and dry, ten to twenty drops of syrup 
of ipecac alone should be given instead of the mixture, and 
when the cough is loosened, the mixture can be again admin- 
istered. When in the course of the affection the breathing 
suddenly becomes labored, and the fever increases, it is fair 
to presume that the case is complicated with pneumonia. 
24 



370 HOME TREATMENT. 

(i) Eruptive fevers, as their name implies, are char- 
acterized by an eruption or exanthema. The most virulent 
of this class is smallpox. The eruption of this disease is of 
the nature of vesicles, or pustules, while that of measles, 
scarlatina, and rose rash is dry, and is properly called a rash. 
Chickenpox, however, has also vesicles and pustules, and 
for this reason it is very liable in times of an epidemic of 
smallpox to be mistaken for a mild form of the latter dis- 
ease. For obvious reasons it is not proper to consider small- 
pox in this connection; its gravity and its management 
require experience, and further, it generally comes under 
special quarantine regulations of the proper constituted 
authorities. 

The eruptive fevers are all divided into three stages, 
namely: a stage of invasion or development; a second 
stage when the eruption appears, and while it lasts; and 
a third stage, that of desquamation, when the eruption begins 
to fade or exfoliate in branny scales. 

(j ) Measles is generally a mild and not serious disease, 
and only attacks the individual but once in a lifetime ; only 
through gross carelessness the disease becomes complicated, 
and then it may become a very dangerous affection. It 
begins with all the symptoms of a common cold. There is 
frequent sneezing, and an acrid muco-serous discharge from 
the nostrils. The eyes are irritable, reddened and watery, 
and there is more or less intolerance of light. The voice 
becomes hoarse and there is always a bronchitis present 
which is characterized by a dry, harsh cough. The patient 
is generally feverish, alternating with chilly sensations or 
shivering; the appetite is poor or absent and in some cases 
there is nausea and vomiting. The children feel drowsy; 
they complain of pain in the head and limbs and want to 
lounge around. The bowels may be constipated, but diar- 
rhoea supervenes in a certain proportion of cases. In nervous 
children convulsions may occur; bleeding from the nose 
and false croup are not infrequently met with in the develop- 



DISEASES OF CHILDREN. 371 

ment of this disease. The duration of the first stage varies 
greatly in different individuals, and comprises a period 
-extending from one to seven days. The eruption begins 
generally on the temples and forehead, whence it extends 
over the head and neck, thence down the back and over the 
•entire body, occupying in its development from thirty-six to 
forty-eight hours. The eruption bears a resemblance to flea 
bites at first; it appears as minute red specks which gradually 
enlarge and become slightly elevated and arrange them- 
selves in circular clusters. The portions of the skin that 
.are free from the eruption retain their white appearance ; the 
face is more or less swollen and the eyelids puffed. In some 
patients there is considerable annoyance from itching in the 
skin. The cough and bronchitis continue to be prominent 
symptoms, and the expectoration, consisting of yellowish 
sputa becomes abundant In some children the fever runs 
very high in this stage and they become delirious and rest- 
less, but this is only temporary, for it generally diminishes 
with the eruption on the third or fourth day. 

When the eruption begins to fade the third stage of the 
affection is inaugurated, and when there exist no complica- 
tions, the patient may now be considered on the way to 
recovery which takes from four to eight days longer. 

The treatment in measles should consist in good nursing, 
rather than in medication. Owing to the inflammation of 
the membranes of the eyes, the patient should be kept in a 
darkened chamber, and the eyes occasionally bathed with a 
solution of borax, by dissolving half a teaspoonful in a tum- 
blerful of water. Good judgment forbids that the patient 
should be sweltered, but that he should be kept comfortably 
warm and never allowed to cool off suddenly is also very 
important. When the eruption is slow to develop a good 
sweat will often bring it out; so will undue exposure, to cold 
drafts and the transportation out of a warm bed into a cold 
one or drinking immoderately of cold drinks either delay 
the development of the eruption or drive it back, and from 



372 HOME TREATMENT. 

this undoubtedly dangerous complications arise, like pneu- 
monia, diphtheritic croup, and convulsions. A mouthful 
of cold water now and then is harmless, but on the whole 
the drinks should be quite warm; the cough and bronchitis 
alone would require that. 

Warm milk thoroughly beaten is the most suitable form 
of diet; broths and soups may be given for a change, so can 
a mixture of equal parts of weak hot tea and milk. The 
bowels should be moved with a mild laxative and if the 
fever runs very high, ten to fifteen drops of the sweet spirits 
of nitre, for a child five years old, in half wineglass of water 
every few hours will generally reduce the temperature. For 
the itching, the skin should be rubbed with equal parts of 
glycerine and warm water. The cough is generally the 
most troublesome feature, and the onty symptom requiring 
regular medication; for this a good general cough mixture 
will serve every purpose, such as: 

Take : Compound mixture of liquorice, 

Syrup of wild cherry, of each 2 ounces 

Mix and give to a child four years old a teaspoonful every 
four hours ; older or younger children in proportion. 

(k) Rose rash, sometimes called false or German measles 
is a comparatively trivial affection and of very little impor- 
tance, for it never has any serious complications and lasts 
only twenty-four or forty-eight hours in the majority of cases. 
It is often mistaken for measles, and one attack affords no 
protection against recurrences. The eruption appears in 
small rose-colored spots or patches which are not elevated. 
It does not commence on the head, but appears on different 
parts of the body. The eruption may be preceded by head- 
ache, loss of appetite, occasionally vomiting, and more or 
less fever or chilly sensations. 

The affection of the eyes and air passages, especially 
the bronchitis which is characteristic of measles, are wanting 
in rose rash, and when we hear of children having had 



DISEASES OF CHILDREN. ■ > >i-\ 

measies several times it is reasonable to presume that it was 
rose rash instead. This eruption hardly calls for treatment, 
but a mild laxative and a regulated diet would fulfill all 
requirements. 

( I) Scarlet fever or scarlatina has received its name from 
the color of its eruption. This affection presents itself dif- 
ferently in different cases. It may be so mild in its attack 
that it constitutes a trifling ailment and again it may be so 
severe that life is seriously threatened, and destroyed in a 
few days. This has formed the basis of dividing scarlatina 
into three varieties, namely: simple scarlatina, diphtheritic 
scarlatina and malignant scarlatina. 

The fever, as a rule, is notably higher than in other erup- 
tive fevers. The attack may begin with a chill, nausea and 
vomiting and headache. There is also bleeding from the 
nose in a certain proportion of cases. The most constant 
sign is redness and more or less swelling of the throat, either 
with or without a sense of soreness and pain in the act of 
sw T allowing. The stage of development lasts in the average 
twenty-four hours, although exceptionally it may appear in 
ii few hours after the first symptoms of the disease have ap- 
peared. The eruption often begins on the back first, and 
from there rapidly spreads over the entire body in twenty- 
four hours. It greatly differs from the eruption in measles 
in not allowing any healthy or white skin to intervene be- 
tween the red specks, but the entire skin has a reddish blush. 
This has given rise to the expression boiled lobster appearance 
in scarlatina, and indeed nothing could illustrate the color 
of the skin better than by comparing the one with the other. 
The eruption is sometimes accompanied with a great deal of 
itching and burning and reaches its fullest development on 
the third day after its first appearance; it lasts from four to 
six days. 

The extent and redness of the eruption varies greatly in 
different individuals, in some it is very slight and transient 



374 HOME TREATMENT. 

while in others there is not a spot as large as a dime which 
is not covered. Yet a very light attack in one patient when 
communicated to another individual may develop in that 
one a most malignant form. One attack secures against a 
recurrence. 

The throat affection seems to modify the eruption of the 
skin for in some instances in which the throat is very bad, 
the skin eruption is comparatively slight. There may bo 
simply a little redness over the tonsils, extending more or 
less over the soft palate, or on the other hand, the disease in 
the throat may become in every respect equal to if not iden- 
tical with the worst type of diphtheria. Some writers con- 
sider the sore throat of scarlatina and that of diphtheria, 
identical, and from a practical point of view there is certainly 
no difference, and the very best results are obtained when 
all severe sore throats of scarlatina are treated precisely as if 
they were diphtheria; this has always been my practice. 

The tongue is quite distinctive of the affection; early in 
the development of the disease it is generally furred, but 
later the coating peels off in patches, and these spots present 
the appearance of a ripe strawberry; sometimes the entire 
surface of the tongue looks as if cayenne pepper or red sand 
had been sprinkled on it. 

The fever generally increases during the eruptive stage, 
and the skin becomes very dry and hot. The pulse may 
run up to 130 to 140 per minute, while the temperature runs 
up as high as 106° Fahrenheit; this state of affairs places 
the patient in imminent danger, he now may become restless 
and even delirious. In a certain proportion of cases the kid- 
neys become involved and albuminuria is a result, but this 
usually passes off with the improvement and recovery of tho 
patient. 

In the third stage the cuticle begins to exfoliate in tho 
form of branny scales. In the absence of serious complica- 
tions this stage marks the beginning of convalescence; tho 



DISEASES OF CHILDREN. 576 

fever subsides, the appetite returns, and the soreness and 
redness of the throat disappear. 

The treatment of this affection always depends upon the 
nature of the case. Simple scarlatina requires no medical 
treatment; the precaution and intelligence which are com- 
prised in good nursing supply everything that is required. 
There is not the same danger of the eruption striking in 
with scarlatina as there is with measles, and the patient 
need not be kept so warmly covered. When the fever runs 
very high, sponging the surface with cool water is very 
grateful and reduces the temperature. After the eruption 
has thoroughly developed, the water for sponging off may 
be very cold without the least danger, and this may be re- 
peated as often as comfort or the high temperature demands. 
To relieve the burning and itching of the skin, the entire 
body should be rubbed over with glycerine night and morn- 
ing; this relieves the system and makes the skin moist and sup- 
ple. If the throat is only reddened, a teaspoonful of chlorate 
of potash dissolved in a cupful of hot water and when cold 
used as a gargle and a teaspoonful of the solution swallowed 
at the same time every two hours is all that is necessary. 
The diphtheritic scarlatina is treated precisely similar to 
and according to the instructions laid down for diphtheria 
in another part of this work. Move the bowels freely with 
the Femina laxative syrup. 

(m) Chickenpox has neither distressing symptoms nor is 
it significant as regards danger. It is an eruptive fever 
which occasionally affects adults, but for the most part 
children. The eruption is generally preceded by a slight 
fever and nausea, and appears first on the body and after- 
wards on the scalp where it is usually more abundant. 
There always remains healthy white skin between the vesi- 
cles, which at first contain a transparent liquid, hence called 
by the Germans waterpox, which afterward becomes cloudy 
or opaline. The eruption begins to dry up from the fifth to 



376 HOME TREATMENT. 

the seventh day forming granular crusts that are sometimes 
followed by pitting. The disease is contagious and develops 
twelve to seventeen days after the exposure. Chickenpox 
claims no treatment; its only point of interest is its resem- 
blance to varioloid, but as a successful vaccination guaran- 
tees against the latter, and as the vesicles of varioloid have 
a central depression while those of chickenpox have not, the 
individuality of the affection is readily established. 






CHAPTER XXXI. 

EMERGENCY TREATMENT IN SUDDEN ACCIDENTS. 

If the author reviews his experience of the last twenty- 
years, he recalls to memory innumerable instances in which 
the lack of a little special knowledge, in cases of sudden ac- 
cidents, did not only incur useless physical suffering, but 
cost lives which otherwise might have been saved. Knowl- 
edge of this nature is not intuitive, but must be acquired 
by study. He therefore offers for the guidance of the 
intelligent reader, common sense advice on the immediate 
management of accidents which are liable to occur at almost 
any moment. 

If a child falls any considerable distance to the ground, 
the system receives a shock varying from the slightest func- 
tional disturbance to complete insensibility. 

In the former case there may probably be only slight 
pallor of the countenance, the ideas become confused, there is 
a disposition to yawn and a feeling of nausea. Young 
children have a disposition to sleep, older ones rub their 
eyes, stare wildly around and even vomit, but after a short 
time they resume their accustomed employment: these symp- 
toms illustrate a slight concussion of the brain. 

When the injury is more serious all the above signs be- 
come aggravated and it may take several hours before the 
normal condition is restored. 

The proper course to pursue in all these accidents is to 
lay the patient on a sofa or bed, with his head slightly ele- 
vated in a darkened chamber free from all noise and con- 
fusion and let him fall to sleep. In ordinary cases reaction 
takes place after a quiet slumber. If however the patient 

(377) 



378 HOME TREATMENT. 

complains of pains in the head and there is irritability of 
temper, the advice of a competent physician becomes neces- 
sary. 

(a) Broken bones or fractures are defined to be a destruc- 
tion of the continuity of one or more of the bones of the 
body. 

Fractures are divided into simple and compound; a sim- 
ple fracture is one in which the bone alone is broken, and in 
which the skin or integument over the seat of the fracture 
remains perfectly intact. A compound fracture is one in 
which the skin and tissues over the fracture are lacerated or 
wounded so that the ends of the broken bones protrude or 
are exposed to view. 

In a case of fracture, no matter of what variety, the first 
object to be accomplished is to carefully remove the patient 
to a place where he may be in a comfortable position. If 
the fracture is in the arm or leg it should be comfortably 
supported on a pillow so as to relieve the injured limb from 
all strain. 

In compound fractures, the wound should be carefully 
covered with a soft clean compress which is kept thoroughly 
wetted with clean cold water until the surgeon arrives. 

Sometimes the circumstances make it necessary to remove 
or transport a patient; then the injured limb must be prop- 
erly supported so that it will remain motionless on the jour- 
ney. In case the arm is fractured the above object is readily 
accomplished by placing it in a sling suspended from tho 
neck. In the case of the lower extremities this object is 
more difficult. The leg should be wrapped in cotton first, 
or some other soft clean substance, after which a slat should 
be placed on the outside and inside of the limb, the same 
length as the limb; over and around these slats strips .of 
muslin or a bandage is wound so as to keep them in place. 
This contrivance forms a temporary or improvised splint 
until the surgeon takes charge of the case. 

(c) Wounds are defined as a recent sudden solution of 



EMERGENCY TREATMENT. 37!) 

continuity in the soft parts or flesh of the body. For the 
sake of convenience in description and for practical purposes, 
wounds are divided into incised, lacerated, contused, punc- 
tured, and poisoned wounds. 

An incised wound is a clean smooth cut made by a sharp 
clean-cutting instrument. 

A lacerated wound is one in which the parts have been 
torn asunder or in which the instrument was blunt or dull. 

A contused wound is one the result of a bruise or blow 
inflicted with a blunt object or by a flat surface. 

A punctured wound is one in which the flesh is pierced 
with a sharp-pointed instrument, like that made with a 
stiletto or bayonet. 

Poisoned wounds are such as have become infected any 
time after the receipt of the injury, or which are the result 
of a bite or sting from a reptile or insect. 

The danger of wounds depends on their extent and 
depth, and upon the locality or organ in which the wound 
is situated. The external wounds, that is those which admit 
of inspection, and situated on the head, trunk or extremities 
are of most frequent occurrence, and the most amenable to 
treatment. 

The treatment of wounds has made wonderful progress 
since the antiseptic discoveries of the eminent surgeon, Sir 
Joseph Lister, and these sound principles have materially in- 
fluenced almost every department of the healing art. It was 
he who first showed how dust-laden air affected injuriously 
the exposed tissues of the wounds; it was he who introduced 
all the precautions as to cleanliness of instruments; the dis- 
infection of hands; the change of clothing; and the purifi- 
cation of sponges and dressings. The magnificent results of 
the practice of modern surgery are not owing to the superior 
skill of the surgeon of our time, but to the magnificent con- 
ception of the idea of cleanliness from which has grown the 
entire superstructure of antiseptic surgery, culminating in 
the grand triumphs of surgical art. To the question What 



380 HOME TREATMENT. 

to do with recent wounds? The answer now becomes self- 
evident; Keep them clean. The best dressing for any clean 
wound is its own secretion carefully protected from the out- 
side world by a fold of clean soft cloth or absorbent cotton, 
wetted with pure cold water. This is to be kept in its proper 
place by means of a bandage, and when it is desirable to 
remove the compress, it must first be thoroughly soaked with 
water so as not to tear or irritate the wound. 

Before Lister's great antiseptic discovery it was the gener- 
ally accepted opinion that suppuration and pus were essential 
to the healing of wounds; this was an error and the opposite 
is now established to be the truth. Pus prevents or rather 
delays the wounds from healing, and suppuration in wounds 
is a fruitful source of blood poisoning. 

If sand, earth, dust or dirt has gotten into or near the 
wound, it must be washed off with clean, fresh water, but 
never employ soiled or infected clothes for that purpose for 
these may poison the wound and do a great deal of mischief. 
After the wound is clean dress it in the manner described in 
a preceding paragraph. 

Poisoned wounds are chiefly punctured. The danger of 
these wounds lies in the possibility that the poison is absorbed 
by the lymphatics and veins, and conveyed to the heart, 
whence the entire blood becomes infected. To prevent this 
a ligature should be tied above the wound, by means of a 
strip of muslin or preferably an elastic suspender, so as to 
check the free return of the blood by the veins and lym- 
phatics. After which the poison should be sucked from the 
wound, or the wound should be cauterized, with carbolic or ni- 
tric acid by means of a sharp-pointed stick dipped into the acid 
and then applied to the wound, ov fired with a red-hot iron, 
crochet or knitting needle. The poison of snakes and taran- 
tulas is neutralized with an alkali; the most efficient seems 
to be spirits of ammonia, but a strong solution of washing 
or even baking soda should be substituted when ammonia is 
not at hand. I would puncture and enlarge the wound of 



EMERGENCY TREATMENT. 381 

the sting with the point of a sharp knife or scissors, so that 
the alkali can come into immediate contact with tho injected 

venom; the patient must be given frequent drinks of whisky, 
brandy or strong wine until a physician arrives to supervise 
further treatment. 

Wounds inflicted by poisonous insects like the bumble- 
bee, honeybee, wasp, hornet, yellow-jacket and mosquitoes 
produce wounds which are instantly followed by a sharp, 
pungent, itching pain, and in a few moments after by a pale, 
circumscribed, inflammatory swelling. Some persons have 
a peculiarity in their constitution that the poison of an in- 
sect gives rise to exceedingly alarming symptoms, such as 
palpitation, nausea, dizziness, dimness of sight and an in- 
describable sense of suffocation. The sting is sometimes left 
in the skin ; for this the wound should be carefully examined, 
and when present drawn out. The most prompt and useful 
application is water of ammonia, or strong salt water, or 
strong soapsuds. Turpentine is also a valuable application. 
If the insect has lodged in the throat, large quantities of 
warm salt water and mustard must be immediately admin- 
istered until the patient has vomited freely, and if there is 
a sense of suffocation leeches and afterwards hot poultices 
should be applied to the neck. If the system has become 
poisoned, and some of the distressing symptoms that were 
above enumerated are present, the internal use of whisky 
or brandy is called for. 

Hemorrhage is common to all wounds, and the loss of 
the blood depends upon the size and nature of the vessel 
that is injured. 

The bleeding that takes place in ordinary superficial 
wounds oozes from minute vessels, the capillaries, and slight 
pressure temporarily applied controls it. When an artery 
is wounded, the blood flows in intermittent jets, or in a run- 
ning pulsating stream from the vessel. The venous blood 
is dark red and flows in a continuous stream and not under 
the same pressure as that coming from the arteries, hence it 
is much easier controlled. 



382 HOME TREATMENT. 

The clotted blood with which a wound may be filled, is 
nature's means of arresting the hemorrhage, and it must 
never be disturbed or washed off, lest this open the blood 
vessels again and thereby renew the bleeding. 

The arrest of hemorrhage is accomplished by the appli- 
cation of cold or ice water, by hot water and by pressure 
upon the arteries. Persons fainting from the loss of blood 
should always be laid with their heads lower than the body; 
cold water should be dashed into their faces so as to restore 
them to consciousness. Moderate hemorrhage from the 
smallest vessels and from the veins generally ceases from 
slight pressure over the wounds or by drawing or pressing 
the edges of the wounds together. In a very short time the 
blood coagulates and forms a temporary plug until the ves- 
sels themselves become permanently sealed by a similar 
process. The pressure must often be continued for a con- 
siderable time until the object has been attained. A folded 
clean cloth or compress is laid over the wound which is the 
source of the hemorrhage, and this is retained by means of a 
properly adjusted bandage. If notwithstanding the pressure 
exerted by the bandage or with the hands, the scarlet blood 
saturates the cloth and continues to flow, it indicates that a 
very large vessel is wounded, and thus life may be seriously 
threatened and in proportion to the magnitude of the 
wounded vessel, a surgeon should now be summoned to 
make a further investigation. Hemorrhage from varicose 
veins of the legs may be checked by a compress fastened 
over the site of the wound by a bandage, but every constric- 
tion around the waist or above the knee by a garter must be 
loosened. If the patient's life is threatened from the bleed- 
ing, the limb must be elevated, and the pressure of the com- 
press increased, or the pressure should be exerted on the 
trunk of the bleeding artery above the wound or injury. 

(d) Burns and scalds are the most commonly fatal injuries 
which occur in modern life. The extended use of steam 
machinery, the universal employment of coal oil, the general 



EMERGENCY TREATMENT. 383 

use of the phosphorus and sulphur matches, and the flow- 
ing manner of woman's dress has materially increased the 
liability of this accident. Of all accidents, burns involve 
the victim in the most agonizing pain and protracted suffer- 
ing. Burns are liable to serious complications; the obstinacy 
to the healing of vast ulcerated surfaces, or the lifelong 
mutilation to which they condemn the unhappy patient, the 
rapid draft they make on the patient's strength, and the 
danger of abscess and ulceration of internal vital organs 
which eventually destroy life. 

These injuries have been classified into three divisions: 
First degree, superficial skin irritation. Second degree, 
cutaneous inflammation. Third degree, devitalization of 
the skin or deeper parts, or carbonization of a mem- 
ber, or the entire body. The first degree is only a super- 
ficial redness, fading without any definite edge into the 
natural skin. This may be produced by the sudden and 
momentary application of flame over a larger portion of the 
body, from an explosion of gas. The local injury is not 
dangerous, and the epidermis remains to protect the surface 
of the true skin until a new layer is produced, as the injured 
one peels off. This hardly calls for any other treatment but 
one or several applications of sweet oil. In the second 
degree, the local injury has penetrated a little deeper, and 
the sudden congestion of blood to the surface, raises the 
epidermis from the cutis in blisters filled with the serum of 
its vessels. Here there is a more serious condition, and 
indeed dangerous in proportion to the extent of surface that 
has become involved. Skirts draped largely with lace, and 
those made of cheese cloth, swiss, and other guazy material 
are of a very inflammable nature, and when once ignited 
blaze into a flame that is almost sure to consume the material 
before it can be extinguished, so that it has been deemed 
advisable on the German stage, to first saturate these mate- 
rials in a solution of sulphate of ammonia to make them 
non-inflammable; this does not interfere with ironing, nor 



384 HOME TREATMENT. 

with the texture or color of the fabric. Another source of 
scalds and burns is the wash boiler or tub on the floor, with 
hot or boiling water in it, so that little children stumble or 
reach into it. Vessels filled with hot water or other fluids 
standing on tables or on stoves within reach of little children, 
who innocently pull the vessel down, pouring its scalding 
contents over them, is another cause of numerous accidents. 

The best course to pursue when skirts or clothing are on 
fire is to roll the victim, so as to smother the flames; but the 
patient herself has rarely enough presence of mind to do this. 
She will run for help, thus fanning the flames, the very worst 
thing she can do. Take the nearest blanket or quilt, or if 
that is not at hand, take an overcoat or wrap; wrap this 
around the burning person and throw her to the floor and 
roll her until the flames are smothered. Then get some 
cold water and pour it on the smoldering clothes until they 
are thoroughly saturated, for the hot charred clothing burns 
into the flesh. In scalding from hot water or steam the cloth- 
ing should be cooled off in the same manner. Cold water 
must be poured over the hot and steaming clothes from head 
to foot, and thus the further action of the heat is suddenly 
checked. The patient should now be carefully removed to 
a warm room and laid in a blanket, on the table or floor. If 
he complains of thirst give a cupful of warm tea or a warm 
whisky toddy. 

Visitors and strangers should now be requested to leave 
the room and the clothing should be removed from the body 
with the greatest care. The scissors or a sharp knife should 
be used to cut away the garments, so as to avoid all possible 
straining and dragging on the patient. The blisters must 
not be torn, and where they are very tense they can be 
pricked with a sharp needle, so as to allow the escape of the 
serum. The epidermis forms the best protection for the 
cutis, and where the skin is stuck to the linen do not tear 
this off, but allow it to remain and cut with a sharp scissors 
around it. The application of cold water generally increases 



EMEBGENCY TREATMENT. 385 

the suffering, but sweet oil, lard oil, vaseline, castor and 
china nut oil will answer for the emergency or until a more 
suitable dressing can be obtained, after which the surface 
should be covered with cotton batting to exclude the air. 
A very useful application is a mixture of equal parts of lime 
water and sweet oil or linseed oil. Carbolized sweet oil is 
another useful dressing and superior to lime water liniment; 
it is made in proportion of half an ounce of carbolic acid to 
one pint of sweet oil; either of the above preparations can be 
poured over the burned surface and then it should be cov- 
ered with cotton batting, or small pieces of soft linen cloth 
can be dipped and saturated in the oil and then applied 
over the burns. The advice of a physician should be sought 
in view of the dangerous complications that may occur from 
extensive burns. 

(e) Frostbite is the result of exposure to cold, and in cer- 
tain regions during the winter months a considerable num- 
ber are liable to this accident. But extreme cold weather is 
not alone responsible for frostbite ; very often this accident 
occurs in moderately cold weather, for instance, if persons 
exhausted from hunger or fatigued from long travels or 
stupefied by alcoholic drink lay themselves down and fall 
asleep, and a cold wind blows over them which withdraws the 
bodily heat, the same effects are accomplished on the system. 

The first effect of dry, cold air is a sense of numbness 
and weight, with a peculiar prickling or tingling, and a rush 
of blood to the surface, giving the skin a lively reddish ap- 
pearance. If the cold is maintained for any length of time 
the blood leaves the surface, which becomes now of a pale 
and whitish aspect, forming a striking contrast to the 
previous redness. When the cold is suddenly applied and 
very intense, the skin exhibits a mottled appearance, which 
is due to the presence of congealed blood in the subcutane- 
ous veins. 

Moist cold has a similar effect on the living tissues to 
dry cold. If the hand is immersed in iced water the blood 
25 



386 HOME TREATMENT. 

rushes immediately to the surface, so that the color of the 
skin increases, which is followed by a marked degree of 
numbness, and an unpleasant burning and tiugling sensa- 
tion. A reaction comes on in a short time, the blood quits 
the surface, and the skin becomes bleached and contracts, 
the tissues underneath also shrink and become painful. 
There is no difference in the effect of either moist or dry cold, 
only that the former is more penetrating and its effects are 
sooner apparent. Those parts of the body that are more di- 
rectly exposed and in which the circulation is not much pro- 
tected by fatty tissue, suffer the most from the effects of cold; 
after exposure for an unusual length of time the toes, feet, 
heels, fingers, hands, nose, and ears, together with the lips 
and cheeks are for this reason oftener affected than other 
parts of the body. Persons whose constitutions are broken 
down by intemperance, starvation and other privations 
which lower the power of resistance are more susceptible to 
this accident. 

The first effect of cold in the general system is bracing 
and stimulating; an agreeable glow is felt over the surface 
of the body and one feels strengthened and exhilarated. 
But if the cold temperature is unusually prolonged this 
agreeable sensation is changed into one of pain and drowsi- 
ness; the brain becomes inactive as if under the influence of 
a powerful opiate or narcotic, and the desire to go to sleep is 
so strong that it requires the greatest effort to keep awake. 
To yield to this inclination to sleep would result in slumber 
that knows no waking, for the blood would now rapidly accu- 
mulate in the internal organs, the breathing would become 
irregular and spasmodic, the nervous functions would soon 
be suspended and death would ensue from general paralysis. 
An individual thus exposed, so as to have become drowsy or 
unconscious and then suddenly brought into a hot room is 
likely to die from congestion of the brain and lungs, or if he 
should revive for a short time, the frost-bitten parts will be 
stricken with mortification. Professor Samuel D. Gross says: 






EMERGENCY TREATMENT. 38*3 

"*'The treatment of frostbite requires no little judgment an<l 
adroitness to conduct it to a successful issue. The great in- 
dication is to recall the affected parts gradually to their nat- 
ural condition by restoring circulation and sensibility, in 
the most gentle and cautious manner, not suddenly, or by 
severe measures. The first thing to be done is to immerse 
them in iced water, or rub them with snow, the friction be- 
ing made as carefully and lightly as possible, lest overaction 
be produced, as they are necessarily greatly weakened. If 
no ice or snow is at hand, the coldest well water that can be 
procured must be used; and if immersion is inconvenient, 
wet cloths are applied, with the precaution of maintaining 
the supply of cold and moisture by constant irrigation. 
Moderate reaction is aimed at and fostered. All warm ap- 
plications, whether dry or moist, are scrupulously refrained 
from; the patient must not approach the fire, nor immerse 
his limbs in hot water, or even be in a warm room. Atten- 
tion to these precepts must on no account be disregarded, 
as its neglect would be almost certainly followed by morti- 
fication or other disastrous consequences." 

(/) Drowning or the submersion of an individual until 
life is destroyed by suffocation is not an uncommon accident. 
"The immediate cause of death in drowning," says Dr. Gross, 
""is suffocation or insufficiency of air. Respiration being thus 
arrested, the blood is unaerated and consequently unfitted 
for life, although the circulation may go on for a short time 
after breathing has completely ceased." 

The Navarino sponge divers whose occupation has ac- 
customed them to live under water the extreme limit, aver- 
age only seventy-six seconds, while the Ceylon pearl divers 
seldom remain under water with impunity more than two- 
thirds of that time. 

Dr. Gross says: "The period at which a person after sub- 
mersion may be resuscitated varies very much in different 
cases and under different circumstances. In some cases, for 
xeasons not always explicable, recovery is found to be im- 



388 HOME TREATMENT. 

possible at the end of one minute. The chances are never 
good after submersion of twice this length of time, especially 
when the water and the air are both uncommonly cold. 

"The treatmentof apncea from drowning must be prompt 
and decided. Every moment of time is most precious. The 
body being removed from the water to a dry place, is imme- 
diately stripped, wiped, and covered with a blanket, especially 
in cold weather. The mouth, nostrils and throat are cleared 
of mucus, froth, and any other substances likely to interfere 
with the admission of air to the lungs ; the tongue is to be- 
pulled out at the corner of the mouth, and prevented from 
falling back upon the glottis; ammonia is rapidly passed to- 
and fro under the nose; and the body is stretched out at 
full length w T ith the face downwards, the forehead resting" 
upon one arm, for the purpose of allowing any water that 
may be in the stomach and air passages to escape by th& 
mouth and nose. If these means do not speedily revive the 
patient, artificial respiration is instituted. For this purpose,, 
the body being placed upon its back, with the head slightly 
elevated, the arms, grasped just above the elbows, are carried 
outwards and upwards from the chest almost perpendicu- 
larly, and retained in this position for about two seconds, 
the object of the procedure being designed to promote the- 
introduction of air into the lungs as in natural breathing. 
They are then lowered and brought closely to the sides of 
the chest, where they are held for the same length of time,, 
to expel the air, the effect being aided by pressure applied 
to the inferior and lateral portions of the chest. These alter- 
nate movements of elevation and depression from twelve ta 
fourteen times a minute, and are performed with all possible 
gentleness. As soon as signs of life are observed, dry warmth 
should be applied to the extremities, the region of the heart, 
loins, and abdomen, a little brandy and water being admin- 
istered, or if deglutition be impracticable, thrown into the- 
rectum." 

(g) Poisons and their antidotes form an important sub- 



EMERGENCY TREATMENT. 389 

ject for our consideration, because many of the poisons are 
among the most useful remedies. The daily accounts in 
the public press of serious and fatal mistakes in the admin- 
istration of medicines, are always due to carelessness and very 
often to criminal negligence. 

No package or bottle should be kept about the house 
without its proper label. 

Those that contain poisonous drugs or chemical prepara- 
tions should be plainly marked Poison, besides the name of 
their contents. 

Vials or packages containing poisonous drugs or chem- 
icals must not be kept on the same shelf and near those 
medicines that are comparatively harmless. 

Always look at the label twice; once before the contents 
are poured out, and a second time, before the dose is swal- 
lowed. Never take medicine in the dark, in the belief that 
you are certain of the right vial and locality; many a sad 
accident has occurred from this venture. 

Sulphuric, nitric, and muriatic acid cause great heat and 
a sensation of burning pain from the mouth down to the 
stomach. Acids are neutralized by alkalies, hence one tea- 
spoonful of washing soda or two teaspoonfuls of bicarbonate 
of soda dissolved in a pint of water should be drunk as soon 
as possible: chalk or powdered magnesia mixed with water 
will also answer the purpose. 

Oxalic acid is frequently mistaken for Epsom salts; lime 
water, chalk or magnesia mixed with water and taken in 
large quantities are antidotes: then administer emetics, which 
act more quickly if the stomach is rilled with fluids; some- 
times the finger run down the throat will excite quick and 
sufficient vomiting. 

Creosote and carbolic acid benumb the stomach so that 
emetics usually will not act, and large quantities of sweet oil 
or castor oil should be first drunk; I prefer the former be- 
cause from one to two pints of it can be taken; after which 
lime water or a solution of Glauber salt (sulphate of sodium) 



390 HOME TREATMENT. 

should be taken; the latter is especially recommended as- 
neutralizing carbolic acid. When circumstances make it 
possible the stomach pump or india rubber siphon tube 
should be at once employed. 

Alkalies, for example, caustic potassa, soda, lye, strong so- 
lution of ammonia, earths and lime are neutralized by drink- 
ing vinegar or lemon or lime juice; afterwards milk in water .. 
and flaxseed tea. 

Arsenic: Give the white of eggs, lime water or chalk and 
water; tablespoonful doses of carbonate of iron, mixed with 
water, or calcined magnesia in the same manner, then evac- 
uate the stomach with an ipecac emetic. 

Corrosive sublimate: Give white of eggs, or wheat flour 
mixed with water; afterwards give an emetic. 

Alcohol: First cleanse out the stomach with an emetic* 
then dash cold water on the head and give frequent doses of 
aromatic spirits of ammonia in water. 

Charcoal or coal gas poisoning: Remove the patient into 
the open air, dash cold water on the head and body and 
stimulate by passing ammonia to and fro under the nostrils,, 
at the same time rubbing the chest briskly. 

Lead : White lead and sugar of lead should first be treated 
with alum emetic, afterwards a cathartic of castor oil or 
Epsom salt. 

Nitrate of silver (lunar caustic) : Give a strong solution 
of common salt, and then emetics. 

Prussic acid or cyanide of potassium. For this no cer- 
tain antidote exists, and it destroys life so suddenly as scarcely 
to allow of use if we had one. When there is time chlorine* 
in solution has been recommended, also water of ammonia 
and cold affusions. 

Opium, laudanum and morphine require the same anti- 
dote. If the patient can swallow an emetic should be given; 
twenty grains of sulphate of zinc and a teaspoonful of pow- 
dered ipecac mixed in a draught of water should be given 
every twenty or thirty minutes until vomiting is insured- 



EMERGENCY TREATMENT. £?91 

A mixture of half teaspoonful of mustard and a tablespoon- 
ful of salt dissolved in a pint or quart of warm water is 
another efficient emetic in these cases. If swallowing is 
impossible the stomach pump must be used. When the 
stomach is cleansed out give strong coffee and acid drinks, 
dash cold water on the head and keep the patient walking. 

Belladonna and black henbane: Give emetics, and after- 
wards a dose of paregoric, and a hot whisky toddy, or a 
cupful of strong tea. 

Nux Vomica and strychnine have no reliable chemical 
antidote; emetics should first be given, or the stomach washed 
out with a siphon tube or stomach pump. Chloroform must 
be employed to control the spasms, then alcoholic stimulants 
should be freely administered. 

Aconite, digitalis, hemlock, lobelia, cantharides, poison- 
ous mushrooms or toadstools, etc., have no certain antidotes. 
Emetics should be immediately given when any of them 
are known to have been taken. Animal charcoal is recom- 
mended to absorb and render harmless organic poisons in 
the stomach; teaspoonful doses mixed with water should be 
given repeatedly, and for those drugs least depressing in 
their action castor oil is also recommended. 

When a prompt emetic is urgently demanded and no 
drugs of any kind are at hand, large quantities of tepid wa- 
ter should be drunk, say half gallon to a gallon; this distends 
the stomach mechanically, and by titillating the throat 
prompt and effective vomiting may be excited; this may 
be repeated as often as necessary and the stomach thoroughly 
washed out. 



CHAPTER XXXII. 

SOMETHING ABOUT DIET. 

It has been truthfully said that "many persons dig their 
graves with their teeth," but, that improper feeding causes 
many a grave to be dug is also true. 

So never feel sorry or disappointed when the family 
physician makes a professional visit, and fails to write a 
prescription, but instead, gives you instruction in the art of 
feeding and nursing the patient. 

Food and stimulants support the strength of the system 
until the struggle between health and disease or between 
life and death is overcome, and thus cure the patient by 
not allowing him to starve. There is a large group of dis- 
eases for which there are no acknowledged remedies, and 
in which a properly selected and regulated diet forms the 
mainstay of successful treatment. This should be combined 
with healthy, clean rooms, proper ventilation, and other hy- 
gienic means which may suggest themselves to the intelli- 
gent practitioner. 

The patient's fancy for this or that article of diet is no 
index, as a rule, of what is best suited for him; invalid ap- 
petites and cravings are abnormal ; they are like tfhat of the 
chlorotic girl who eats chalk and slate pencils, instead of 
wholesome food and some preparation of iron. 

An aversion to food is also no criterion of the patient's 
need for nourishment, for the sense of taste is generally 
blunted or perverted. The desire for food is lost in all dis- 
eases of a catarrhal nature of the mouth or stomach, and 
in those that are characterized by high temperature. In 
typhoid fever and diseases of a typhoid nature this is always 
the case. 

(392) 



SOMETHING ABOUT DIET. 393 

With children this aversion to food is greater and more 
general than with adults; and it must be made a rule that 
their refusal to take nourishment must not be extended 
beyond several days, otherwise they fail so rapidly in con- 
junction with the disease as to perish from exhaustion. 

The repugnance to food arises from abnormal conditions 
that are generally localized in the mouth and especially in 
the parts of the tongue which are supplied by the nerves of 
taste; these nerves are the lingual branch of the trifacial and 
the glasso-pharyngeal. But notwithstanding that the food 
is almost tasteless, when it gets into the stomach it is 
retained and properly digested and the patient feels better 
for having taken it. An appetite can be thus cultivated, 
and after a few days of coaxing or perhaps of forcible feed- 
ing, which in children who are failing rapidly becomes 
necessary in order to save them, the taste and desire for nour- 
ishment become natural or restored. Quite often patients 
beg and plead not to be given food; but in wasting diseases 
it should be insisted that some at least should be taken (al- 
ways liquid of course), and when they are sufficiently ra- 
tional they will always afterward admit that the nourish- 
ment did them good. 

Liquid food or nourishment and no other is suitable for 
a sick person ; an invalid can drink food when it would be 
impossible for him to swallow solid material. I have often 
seen the whim of patients who craved meat indulged ; they 
got a juicy porterhouse steak with the understanding that 
it was to be thoroughly masticated before swallowing. 
As a rule, the patient is disappointed with his own bill 
of fare, and after trying one or two mouthfuls orders 
the meat taken away with the remark that it is as dry 
as a chip. But this same person will drink a milk punch, 
a thin gruel with the yellow or all of an egg beaten into it, 
with some degree of relish ; salt should always be added and 
indeed, as much as the taste will permit, but sugar should 
be used as sparingly as possible. Salt is what is needed 



394 HOME TREATMENT. 

above all other seasoning ; the system requires the chlorides 
for they are wasted in fevers, but even in health, the chlorides 
are very essential and salt is the best one we have; salt is 
the source of the hydrochloric acid in the stomach and one 
of the most important factors in albuminous digestion. 

The saliva is not secreted in sufficient quantity in fever 
to allow insalivation of food, or to moisten the solid morsel 
sufficiently to permit its being swallowed without a choking 
sensation as it glides into the stomach. A person prostrated 
by disease has not the strength to masticate solid food and 
that is another reason why liquid food is to be given. 

The famous physiologist, Dr. E. Brown-Sequard, is the 
author of a method for feeding the sick peculiarly his own, 
namely, that of administering small quantities of food at short 
intervals. He would give a glassful of milk punch in table- 
spoonful doses, repeating every ten or fifteen minutes; this 
method is advised for the treatment and cure of dyspepsia, 
anaemia, chlorosis, nervous diseases and even organic diseases 
of the stomach. No particular kind of food was selected for 
this treatment; butter, milk, cheese, and meats, bread and 
potatoes were alike to be given in small quantities and at 
short intervals. One or two mouthfuls even to be eaten at 
a time, and then repeated in ten or fifteen minutes, until 
thirty to forty ounces are consumed daily. This system 
never became a recognized expedient, it is wrong in theory, 
and certainly in practice; while it may be applicable in 
isolated cases, they would be so very few that this method 
of feeding forms the exception and not the rule. 

Cases are frequently met with, especially in infants and 
older children whose digestion has been completely ruined by 
being fed too often. These cases are not really overfed, be- 
cause the entire amount in the twenty-four hours, does not 
exceed the requisite quantity; but giving the food in driblets 
and at short intervals, causes lactic fermentation, or in plain 
English, the food sours on the stomach and does not digest, 
as it would do if a proper time were interposed between each 



SOMETHING ABOUT DIET. 395 

feeding. As soon as the patients are fed at regular and longer 
intervals, say,from two to four hours, the indigestion corrects 
itself. During the interval, between the time set for feeding, 
the children will naturally cry; this is interpreted by the 
mother or nurse as a sign of hunger, but nothing is oftener 
further from the truth. The child cries generally for one of 
three reasons: one of these may be that it wants to be taken 
up, and dandled or rocked, to which previous indulgences 
have accustomed it; or it may have pain in the stomach and 
bowels as a natural result of indigestion or flatulence; or the 
child may cry from thirst or a sensation of dryness in the 
mouth and throat; in any event, additional food would only 
prove injurious. There is no objection against giving nurs- 
lings cold water between their meals when they are thirsty 
or feverish, but warm aromatic tea is so very much superior 
that I consider it one of the essentials of the nursery. I mean 
fennel seed tea, of which a sufficient quantity should be pre- 
pared every morning to last twenty-four hours ; this should 
be strained and sweetened, then set aside for further use. 
When the child is restless, between meals, some of the tea 
should be warmed, and given from the nursing bottle until 
it is satisfied, for the tea soothes the pain, quenches the thirst 
and dispels the flatus. 

There are also physiological reasons for these longer in- 
tervals between nursing; they allow the stomach sufficient 
time to dispose of its contents before another mess is given 
to disturb the digestion of former food, which is as yet incom- 
plete. There is another immense advantage in having the 
length of time between two meals from two to four hours; 
it allows time for medication and other necessary manage- 
ment of the sick, for sponging off with cold water in fevers, 
and many other things which are necessary for the patient's 
comfort and convalescence, and which can only be carried 
out between the times the nourishment is given. A memo- 
randum should be kept in the sick room and the time and 
hour noted when everything becomes due in proper order; 
this avoids confusion and lessens labor. 



396 HOME TREATMENT. 

Digestion is the solution of the food in the stomach for 
purposes of nutrition. Nitrogenous materials, egg, meat, 
muscle are digested principally in the stomach, but not en- 
tirely so, because the particles of albuminous food which 
j pass from the stomach into the upper portion of the small 
' intestine come into contact with the pancreatic fluid, which 
is the digestive agent for fats and starches, but which pos- 
sesses also powerful digestive properties for nitrogenous or 
albuminous substances and even in a greater degree than 
the gastric juice of the stomach, which has a strong acid re- 
action, while the pancreatic juice has an alkali reaction; 
here is a very interesting illustration how similar digestive 
processes are accomplished under opposite chemical condi- 
tions. The intelligent reader must not fail to observe, from 
what has been said, that there are two distinctly different di- 
gestive processes, namely one going on in the stomach and 
another equally as important taking place in the small intes- 
tines. 

Pepsin is the active principle of the gastric juice, held 
in solution in a clear colorless liquid, principally water; it 
has a sour taste and a peculiar characteristic sour smell. 
The length of time required by the gastric fluid to dissolve 
the food depends greatly upon the minuteness of the divis- 
ion of the solid substances to be acted upon, as well as upon 
the quantity and quality of the peptic fluid. 

The pepsin changes the physical properties of nitrog- 
enous substances so as to make them soluble in water in 
any proportion and when the albuminoids have acquired 
this property they are termed peptones; peptones are simply 
nitrogenous food which has been modified to fit it for ab- 
sorption and nutrition of the body. 

In the tissues of the body there are continual changes 
going on, termed in technical language tissue metamorpho- 
sis; the waste products that are thus formed constitute a 
group of highly nitrogenized substances, which in a healthy 
condition of the system are eliminated by the kidneys. 



SOMETHING ABOUT MET. 39* 

These nitrogenized products are urea, urate of soda and uric 
acid; the accumulation of any of these substances in the 
blood gives rise to disease; the former is the cause of uraemia 
and uraemic convulsions, and the latter have been detected 
in the blood and exudations in cases of gouty and rheumatic 
disease. The characteristic gouty deposit is urate of soda, 
due to an excess of nitrogenous elements of the blood. An 
excess of uric acid constitutes a disease which is first recog- 
nized by a reddish crystalline sediment in the urine; the 
term lithiasis has been employed to denote this peculiarity. 
These lithates are always to be found in the urine of high liv- 
ers and are due to an excessive consumption of nitrogenous 
food. The great English authority, Dr. Murchison, looks 
upon the excessive production of uric acid, or lithic acid, as 
it is sometimes called, as due to one of two causes and some- 
times to both, namely to the excessive consumption of nitrog- 
enous food, or to an inability of the liver to perform its duty, 
which among other things is to dispose of the nitrogenous 
waste products. From this point of view lithates or brick 
dust deposits in the urine are no sign that the kidneys are 
deranged, but quite the reverse may be true when the kidneys 
are overburdened in eliminating this excessive waste, for they 
are performing extra duty, which excess in living or a slug- 
gish liver imposes upon them, and this may excite inflam- 
mation in the tissues of the kidneys and develop into what 
is known as Bright's disease. 

This very interesting exposition of the deposit of lithates 
or gravel in the urine will naturally suggest that when the 
urine is overloaded with these nitrogenous products nitrog- 
enous food like eggs, cheese, beef, etc., should not be eaten 
for awhile, and that a vegetable diet should be principally 
relied upon, thus giving the liver a vacation; the diet 
should be supplemented with plenty of clean fresh water, 
and no liquors of any sort should be taken by those whose 
liver is affected. 

Starch, sugar and fat are composed of carbon, hydrogen 



398 HOME TREATMENT. 

and oxygen; starches and sugars are termed carbo-hydrates; 
because the hydrogen and oxygen is always present in them 
in equal atomic weights so as to represent water; while in 
the fats the oxygen is considerably less. This is exempli- 
fied by comparing the chemical equivalents of starch and 
cane sugar with those of fats : 

Starch C 12 H 10 O 10 Oleine C 94 H 87 15 

Cane sugar. . . .C ]2 H u O n Margarine C^ H 75 12 

When starch is boiled with diluted nitric, sulphuric or 
muriatic acid for thirty-six to forty hours, it becomes color- 
less and thin like water, and is converted into a species of 
sugar. A similar process takes place when starch is taken 
as food, the diastase of the saliva, and the pancreatic and in- 
testinal juices change starch into glucose, in which form it 
is ready for nutrition. 

Cane and other sugars introduced into the system as in- 
gredients of fruits and vegetables are not absorbed as such ? 
but undergo a process of digestion which converts them into 
grape sugar or glucose; after that they are suitable for nutri- 
tion and absorption into the blood, but not before. 

The digestion of starches and sugars has been incidentally 
referred to as not taking place in the stomach but in the 
upper portion of the small intestine, through the agency of 
the pancreatic juice which has the peculiar property of con- 
verting farinaceous and saccharine matters into grape sugar- 
But this transformation into grape sugar is not the final 
product of digestion. In the normal process of intestinal ab- 
sorption the grape sugar is taken up by the portal capillary 
vessels and carried to the liver, where under the influence of 
this organ it is changed into liver sugar or glycogen, and it is 
as glycogen that it again enters the circulation, to disappear 
in the lungs. But if the liver from disease or other causes 
fails to perform this task, the glucose passes through the organ 
unaltered, and as such again enters the circulation where it 
acts as an irritant and finally is eliminated by the kidneys 
in the urine giving rise to the affection known as diabetes. 



SOMETHING ABOUT DIET. 399 

We have learned that there is a stomachic digestion and 
an intestinal digestion, the former principally for meats, or 
that class which are now called nitrogenous foods, while the 
latter is confined generally to starches and fats. This phys- 
iological fact suggested the idea of feeding dyspeptics only 
on such food as is not acted upon in the stomach, but 
passes beyond that cavity to become digested in the small 
intestines, giving the stomach a rest as it were so that it 
may recuperate and gain strength while the system is be- 
ing fed by farinaceous aliments. While a superficial glance 
justified such a procedure, a moment's reflection proves it to 
be a delusion, and for this reason, that there will be an un- 
avoidable irritation of the stomach which the journey of the 
farinaceous material occasions in its passage through the 
stomach, and the insufficient nutritive value of a simple non- 
nitrogenous diet causes a rapid loss of tissue and bodily 
strength ; hence this course proved itself impracticable and 
was abandoned. Then again the experiment was tried of 
putting a certain class of dyspeptics on a purely meat diet; this 
had one fault common with the former plan; it was also too 
one-sided, and the system suffered for want of fat and starch, 
and secondly peptones were not always formed in the stomach 
from a deficiency of the gastric juice or an impairment of its 
quality, so that this method was also abandoned. 

Fats belong to the starches and sugars as heat producers; 
they are insoluble in water, and by boiling them in caustic 
alkali they are decomposed into soap and glycerine. In the 
cavity of the stomach fats remain unaltered; the heat of the 
stomach may melt or liquefy them, but in no other way are 
they changed. They are also digested, like the starches, in 
the small intestine by the action of the pancreatic juice 
which possesses the remarkable property when brought in con- 
tact w T ith fatty or oily matter at the temperature of the body 
of emulsifying it, and of converting the fats into a milky, 
white, opaque looking fluid, by a minute subdivision of the 
oily particles. This emulsion of the fatty and other sub- 



400 HOME TREATMENT. 

stances of the food is termed chyle, and as such, the fatty sub- 
stances are ready for absorption by the absorbents of the in- 
testinal tract. Experience teaches that a deficiency of fat 
causes scrofulous diseases, and this class of patients have gen- 
erally a repugnance for fat; this is another illustration of the 
unreliability of patients to choose their own food. Professor 
John H. Bennet first pointed out the usefulness of cod liver 
oil in consumption and other scrofulous diseases, and directed 
attention to the value of fat in the nutrition of the body. 

Dr. Ferguson made extensive observations on the little 
children of the factory operatives of Lancashire, Eng. The 
children were principally fed on tea or water and bread, 
little or no fat, bacon, butter or cream, and they grew up 
into puny and stunted men and women, while those who 
had a bread and milk diet grew into hardier and finer hu- 
man specimens. 

Fat is also an essential food for the brain and general 
nervous system; the lean are the nervous patients and not 
the fat and sleek, hence fatty food is considered an impor- 
tant diet for this class of diseases. The brain and nerve fat 
is called "lecithin" and a little phosphorus enters into its 
composition. Chronic obstinate neuralgia has often been 
cured by the administration of cod liver oil. 

Milk is the only single article of diet which possesses in 
itself all the properties to supply the wants of the system, 
and it may be profitable to give this subject more than pass- 
ing notice. It is the natural and most wholesome food for 
the infant when it can suck it from its mother's breast; in- 
stinctively the newborn rolls its little head hither and thither 
in search for this fountain of infantile life and however great 
the skill of the chemist in approaching the composition of 
mother's milk, he can never produce an equally good substi- 
tute. Milk contains all the principles which are necessary for 
human food, the nitrogenous, the oleaginous and the sac- 
charine, and these are blended in such proportion that milk 
is adapted for the complete nourishment of the young and 



SOMETHING ABOUT 1)1 IT. 401 

old. In no other single substance supplied by nature 
does a similar combination exist; it contains the material 
for the consolidation of bone and for the formation of the n < 1 
blood corpuscles, by carrying in solution the phosphates of 
lime, magnesia and iron; in this respect an analysis of milk 
shows a remarkable similarity to blood. The proportions of 
the different constituents of milk are liable to great varia- 
tions and are greatly influenced by the nature of the food. 
Dr. Playfair of London, who has made some interesting 
researches regarding the milk of the cow, has demonstrated 
that the amount of butter depends in part upon the quantity 
of oily matter in the food and in part on the amount of ex- 
ercise which the animal takes; and upon the warmth of the 
atmosphere in which it is kept. Exercise and cold weather 
eliminate the oily matter or butter, in the form of carbonic 
acid and water, while rest and warmth diminish this drain 
by favoring its passage into milk. On the other hand, the 
proportion of the cheesy matter is increased by exercise. 

In Switzerland, where the cattle pasture in very exposed 
situations and where, from the rolling of the country, they 
are obliged to use a great deal of muscular exertion the 
quantity of butter yielded by the cows is very small, while 
the cheese is in unusually large proportions; but the same 
cattle when stall fed give a large quantity of butter and 
very little cheese. 

The character of the food will decide the nature and 
healthfullness of the milk. The best food for milch cows is 
bran or middlings mixed with well-seasoned and sweet-cut 
hay, and this mixture thoroughly scalded and saturated 
w T ith boiling water; a little flaxseed oil cake, should be 
added occasionally, for it enriches the milk and keeps the 
cattle in good condition ; during the day the cows should be 
in the open air; they should not be irritated by dogs, or 
made to run or trot; these things will affect the milk injuri- 
ously. To feed cows on kitchen garbage or swill of any 
sort will taint the milk so that the offensive odors of the 
26 



402 HOME TREATMENT. 

swill can be readily detected, especially after the milk has 
stood awhile; such milk is particularly dangerous to infants 
and should at once be discontinued. Distillery slops are 
often fed to cattle in large cities; these are not only produc- 
tive of poisonous milk but also injure the cattle so that they be- 
come salivated and lose their teeth after a few years of this diet. 
Brewers' grains are not open to the same objection as whisky 
slops; a certain proportion of brewers' grains added to the 
cut food increases the flow of milk. In all large towns there 
are families who keep one or two cows and who sell the milk 
as a means of making a livelihood: as a rule these cattle are 
fed on swill, and not upon the best quality of food, and al- 
though this milk is recommended as being pure and one 
cow's milk, it is as a rule not good, for the stalls and the food 
do not come up to the requirements for wholesome milk. 

I have always found a healthier and purer milk from the 
dairies run on a large scale, and outside of the centers of 
population. The cattle look healthier, have better food, 
good pasturage and pure country air, and if the milk is 
properly chilled or cooled off before it is poured into the 
wagon cans, country dairy milk is to be greatly preferred over 
city milk. The animal heat should have left the milk 
before it is put into cans for transportation, for it is the ani- 
mal heat in tightly closed vessels which causes the chemical 
changes that encourage the development of organic milk 
poisons or so-called ptomaines. 

Milk promiscuously mixed from a group of apparently 
healthy cows is preferable to that of one cow, and for several 
reasons; the honesty of dairymen is doubtful, for they will 
not take the extra trouble to keep the milk of one cow apart 
when the cows are being milked; again tuberculosis or con- 
sumption in all its stages is a common disease among cattle, 
and quite often a milch cow has tuberculosis when she seems 
healthy. If a child should subsist on the milk from a 
tuberculous cow, serious consequences would undoubtedly 
ensue, but if this milk had been mixed with that of thirty 



SOMETHING ABOUT DIET. 403 

or forty healthy cows, the danger of infection would be cor- 
respondingly lessened. 

Cow's milk should average 12 per cent, of cream; if it 
contain less than 8 per cent, it is probable that the milk is 
watered or that it was skimmed. A cream gauge is a cylin- 
drical glass vessel about one and a half inches in diameter 
and eight inches high, with a capacity of 12 fluidounces. 
This tubular measure is graduated so as to make it possible 
to read off from the top downwards 1, 2, 3, etc., parts or 
drams of cream which gradually rises to the surface. This 
glass is filled with the suspected specimen of milk up to the 
highest mark and set aside for 24 hours, at an ordinary tem- 
perature; at the expiration of that time the quantity of 
cream which rose to the surface of the milk is read off, and in 
this manner it is easy to see the proportion of cream to the en- 
tire bulk of milk tested. Above it was stated that 12 per cent, 
is an average for good milk, and 14 per cent, is extra good, 
while 8 per cent, is the lowest that is permissible. If the per- 
centage falls below 8 per cent, it is a sign that the milk has 
been skimmed, and if the density or specific gravity is below 
27 degrees, then it is to be presumed that the milk has also 
been watered, for sometimes the milk is both skimmed and 
watered. 

The density or specific gravity of milk gives an approxi- 
mate idea of the quantity of solid matter a given specimen 
submitted for examination contains, as compared with pure 
water. The lactometer or galactometer is a kind of hydro- 
meter, but specially graduated to readily read off the density 
which pure milk should have. Pure milk at a temperature 
of 55 to 60 degrees should have a specific gravity varying 
between 27 and 33 degrees and if the sample falls below 27 
degrees, it is to be presumed that water has been added. 
The density of diluted milk is sometimes maintained by 
boiled starch water; this can be detected by adding a few 
drops of tincture of iodine, which changes the starch into a 
beautiful violet blue, also giving the adulterated milk a 
similar tint. 



404 HOME TREATMENT. 

It must always be remembered that while milk presents 
itself in a liquid form it becomes a semi-solid in the stom- 
ach in the ordinary process of digestion; this change is- 
accomplished by the action of the gastric ferment, curdling 
the milk. Milk is not a diluent for solid foods and it should 
never be drank as a substitute for water when other solid 
food has been eaten. The practice of eating a regular meal 
of meat and vegetables and drinking milk at the same time- 
invariably overloads the stomach, and if it does not injure 
the digestion immediately it is sure to do so in time; it also 
furnishes an oversupply of nitrogenous food, developing an 
excess of lithates or uric acid, and this burdens the liver and 
kidneys. If a person is fond of milk it is most excellent as 
a principal article of diet at a meal, and indeed nothing is 
better than a bowl of well-prepared mush or a few slices of 
bread with a pint of fresh milk for either breakfast or supper. 

Boiled milk has considerable healing and binding virtues; 
it may be thickened with a teaspoonful of wheat flour to the 
pint, and taken quite warm; as a household remedy, it is 
one of the most valuable in ordinary cases of diarrhoea, but 
no other food should be taken until the cure is effected. 

The milk cure is a well-established and recognized expe- 
dient for the relief and cure of a certain class of patients, 
and as the success of the regimen depends upon an intelli- 
gent employment of the fluid, it becomes necessary to enter 
somewhat into the detail of its administration. 

The milk-shake, that is milk shaken in a tumbler or 
beaten with an eggbeater for several minutes is frequently 
borne by persons who cannot digest milk which has not been, 
so treated; then again, a teaspoonful of mush or gruel added 
to a tumblerful of milk and thoroughly beaten, divides the 
curd mechanically when it forms in the stomach, and so 
makes the milk much more soluble by the gastric juice. 

Milk should never be drank cold, but at a temperature of 
about 100° F., wdrich is about, as warm as it comes from the 
cow, for cold delays the curdling and hence the digestion 



SOMETHING ABOUT DIET, 405 

of the milk, and gives it time to develop acid or lactic 
fermentation in the stomach, and this may cause indi- 
gestion; a pinch of salt should be added to milk, it assists 
in its digestion. There must be certain periods at which to 
take milk, allowing a definite interval for the milk to digesl ; 
taking milk in mouth mis, for instance as a drink instead 
of water is wrong, for this will ferment and occasion indiges- 
tion. The proper length to intervene between each meal of 
milk is four hours; breakfast 8 o'clock, dinner at 12 o'clock, 
lunch at 4 and supper at 8 o'clock; if the patient is consid- 
erably exhausted, the time between 8 o'clock in the evening 
and the same hour in the morning may be too long, and if 
the patient is awake, a meal should be given at midnight. 

The quantity of milk which may be taken for one meal 
is of great importance, for there is the same danger of taking 
too much of this food as of any other. The average quan- 
tity to begin with must not exceed half a pint, and when 
the appetite is capricious one-fourth of a pint is sufficient. 
It is now fully established that a grown person can be fairly 
well nourished for quite a while on one quart of milk in the 
twenty-four hours. 

It is also of considerable importance to the patient that 
he does not gulp the milk as this would cause it to curd into 
a large cohesive mass of casein, which would be slowly dis- 
solved or acted upon by the gastric juice, and might give 
rise to distress from indigestion. If, on the other hand, the 
patient sips the milk slowly, or eats it w T ith a spoon, the 
curds will be small and flaky particles which even a weak 
stomach may digest. There are quite a number of persons 
w T ho like milk, yet whose stomachs do not take to it, and for 
these a milk cure might be just the thing. It requires often 
a great deal of ingenuity to devise a plan whereby the ob- 
stacle may be overcome. The first step should be to shorten 
the interval between each meal and lessen the quantity cor- 
respondingly; thus to give the patient the milk every hour 
would imply that he was to take only one-fourth as much at 



406 HOME TREATMENT. 

a time as if he took it every four hours. Perhaps the milk 
would digest more easily if it were first beaten and slightly 
seasoned with a pinch of salt, or if a little strained gruel 
were added to mechanically divide the curd. A soda cracker, 
toasted bread, or the rind of thoroughly baked wheaten bread 
is an excellent substitute for dividing the cheesy substance 
of the milk when it gets into the stomach. They should not 
be soaked or dipped into the milk and eaten together, but 
eaten dry and thoroughly masticated until the saliva has re- 
duced the bread to a soft pulp, after which a spoonful of milk 
should be taken and the bread stuff washed down. The 
saliva serves another useful purpose besides moistening the 
bread as it changes the starchy substance into sugar. 

In other cases the milk sours on the stomach, and then 
some antacid or alkali, like lime water or bicarbonate of 
soda should be added for several days or until the disposi- 
tion to lactic fermentation has subsided. If notwithstanding 
every precaution, waterbrash, heartburn, or a heavy op- 
pressed pain in the stomach occurs, or if sourish, slimy 
secretions are vomited, the milk cure must be abandoned 
for something else. 

Diarrhceal diseases of infants who are fed on cow's milk 
are caused, in many instances, by germs or spores that get 
into the milk from lack of proper cleanliness and from the 
unavoidable exposure of the fluid to the atmosphere of 
stables and dairy rooms where the milk is handled before 
transportation to consumers. To obviate the danger of feed- 
ing nurslings with infected milk, and to destroy the vitality 
of germs which find access to the milk, methods have been 
devised for sterilizing the milk. This process was first pro- 
posed in 1886 by Professor Soxhlet, and has ever since gained 
favor with the profession ; it consists of exposing the milk to 
a temperature of live steam or boiling water for about forty- 
five minutes. In New York City there are two reliable firms 
which sterilize milk at the dairy in the country and ship it 
to the city. 



SOMETHING ABOUT DIET. 407 

In all the methods of sterilization the milk is placed in 
six or eight-ounce bottles and set on a tray or shelf, which 
stands above the water at the bottom of a vessel, the cover 
then applied and the water made to boil forty-five minutes; 
a perforated stopper is inserted into each flask, admitting of 
the escape of air and gases at the beginning of the heating 
process. The stopper may consist of cork with a glass tube 
in the center, or cotton, or of rubber with a channel a part 
of the distance on one side. If necessary the family can im- 
provise their own apparatus; an inverted tin pan will serve 
the purpose of a tray to support the nursing bottles, and this 
placed in the bottom of an ordinary tin vessel with a cover 
completes the contrivance. The milk is to be prepared as it 
is to be administered, that is, the proper quantity of water, 
a little sugar, and the point of a penknifeful of bicarbonate 
of soda added, and distributed among as many eight-ounce 
flasks or nursing bottles as the child is fed during the 
twenty-four hours; thus if fed every four hours the milk 
should be distributed among six flasks, and if fed every 
three hours, it would require eight flasks. When the milk 
has been sterilized, it keeps sweet for an indefinite period 
at ordinary temperature ; the bottle is to be well shaken to 
mix the cream before the cork is removed and the nipple 
applied. 

When an apparatus or a sufficient number of flasks can- 
not be readily obtained I have the milk boiled in a fruit jar 
after the manner of making beef tea, as follows: A quart 
preserve jar is filled with milk, obtained not later than four 
to six hours after milking, the cover is lightly put on, to 
allow the escape of air and gases, and then the jar is put 
into a vessel, on the bottom of which an inverted pan has 
been placed so that the preserve jar does not rest on the 
bottom of the vessel where the heat would crack it; the 
vessel is then to be filled a third with water, and this 
boiled for an hour, after which the jar is carefully closed, 
as in preserving fruit, until wanted for use. The milk 



408 HOME TREATMENT. 

should be kept in a cool and clean place, and only as much 
measured out each time as is required for one mess, after 
which immediately close the jar. The water that is to be 
used for diluting the milk must have been thoroughly boiled; 
it is always better to prepare and dilute the milk before ster- 
ilizing it for very young infants, but when they are a year 
or more old, the boiling water may be added at each meal. 

The casein, which is the curd or coagulable part of milk, 
differs greatly in its physical property in the milk of the 
cow from that in human milk. Mother's milk curds in soft 
flaky coagula which are readily dissolved in the infant's 
stomach, while cow's milk curds in a semi-solid conglom- 
erate coagulum which the cavity of the child's stomach is 
often unable to tolerate nor the gastric juice to penetrate 
and dissolve. It is this heavy curd which forms the main 
objectionable feature of cow's milk as a substitute for that 
of the mother. This can be greatly modified by first thor- 
oughly beating or churning the cow's milk with an egg 
beater, and afterwards scalding it as above described; the 
milk treated in this manner curds light and flaky. But it 
must not be presumed that the physical characteristic of 
casein is the only peculiarity of cow's milk in comparison 
with mother's milk, for this is not so; it also differs in quan- 
tity, that is, mother's milk has less of casein, a fact which 
may be better understood by the following chemical analysis 
of both: 

Human milk. Cow's milk. 

Water 87.09 87.0 

Casein and albumen 2.48 3.72 

Fat 3.90 3.66 

Sugar of milk 6-04 4.92 

Phosphatic salts 0.49 0.70 

100.00 100.00 

There are some children who are unable to digest cow's 
milk in any form, either from a peculiarity of constitution, 



SOMETHING ABOUT DIET. 109 

or from a derangement of the digestive apparatus ; the milk, 
no matter how prepared, passes through them curdled, in 
lumps and undigested; to continue feeding infants on milk, 
notwithstanding this symptom would in all probability sac- 
rifice the life of the child If curds persist in the stools 
milk is to be withheld for a time, and crushed wheat, barley 
gruel or other diluents should be given alone or in combi- 
nation with the thoroughly beaten white of egg. This 
treatment must be continued for several days and in some 
cases for several weeks. 

Whey prepared from sweet and pure milk has often been 
borne by delicate and suffering infants, when nothing else 
could be retained. An examination into the chemical com- 
position of whey reveals astonishing nutritive virtue, which 
it holds in solution; the following table shows the propor- 
tional constituents in one hundred parts: 

Water 93.31 

Nitrogenous matter 0.82 

Fat or butter 0.24 

Sugar of milk 4.98 

Fixed salt 0.65 

When the whey is the product of soured milk, 0.33 or more 
of lactic acid is to be added to this analysis, and the same 
amount deducted from the sugar of milk. Essence of pepsin 
will curd lukewarm milk, not warmer than can be agreeably 
borne by the mouth ; a temperature higher than one hundred 
and fifteen degrees Fahrenheit destroys thecurdling principle 
of the pepsin. The quantity of essence of pepsin to be used to 
the pint of milk depends on the strength of the preparation; 
usually a teaspoonful or two is added and stirred just enough 
to mix; let it stand till firmly curded, then beat up with a 
fork until the curd is finely divided; now strain and the 
whey is ready for use; it should be sweetened a little; sugar 
of milk, if pure, would be the best, otherwise white cane 
sugar may be used. A newborn babe will require a table- 
spoonful to begin with, every two hours, always slightly 



410 HOME TREATMENT. 

warmed. It is particularly essential to keep everything 
clean, especially the tube and nipple; these are to be brushed 
and cleaned after each meal, and then laid on a clean dry 
plate for future use; the nursing bottle too must be rinsed 
and drained. The prevalent custom of keeping the tube, 
nipple and bottle in water after they are washed is a bad 
one, for to have them sweet and pure they should be allowed 
to dry out between times. 

Condensed milk is often a valuable substitute for fresh 
cow's milk; its utility, is probably due to the employment 
of heat in its manufacture, which destroys the germs or 
spores that find their way into all milk, and to the scald- 
ing of the casein which modifies its physical character so 
that it no longer curds into large lumps when in the stomach, 
but into smaller flakes. There are different brands in the 
market, and even the best of them may be too old and shop 
worn; they then become thick and dark in which condition 
they are no longer fit for infants' food. The Eagle and 
Anglo-Swiss are among the best varieties; others contain 
too much sugar, while some are adulterated with starch or 
flour. A heaping teaspoonful of condensed milk to a tea- 
cupful of warm water, previously boiled, is the average 
strength, although better results are obtained when a thin 
gruel of corn starch or arrowroot is employed instead of plain 
water; when the child grows older cracked or rolled oats 
or graham flour may be substituted for the arrowroot. The 
gruel is prepared in the following manner : take half a tea- 
cupful of oatmeal or graham flour, saturate first with cold 
water, then stir slowly into three pints of boiling water; add 
a pinch of salt and boil over a slow fire for three-quarters of 
an hour, stirring constantly so that it will not scorch on the 
bottom ; then strain, and if it has boiled down to less than a 
quart of gruel, add a sufficient quantity of boiling water 
through the strainer to make it measure a quart. 

The gruel is to be prepared fresh every morning, and the 
above quantity will last about twenty-four hours. It should 



SOMETHING A.BOUT DIET. 411 

be kept in a porcelain or glass pitcher covered with a nap- 
kin, and set aside in a clean cool place. At regular meal- 
times take out the required quantity, warm in a little agate 
saucepan, kept only for this purpose, and when warmed add 
the condensed milk, stirring until it is dissolved. This 
makes a fine cream-like food, agreeable to take and very 
nourishing if well borne by the stomach. The stools may 
become too loose at times from the oat or wheaten gruel, then 
this gruel should at once be changed for that of corn starch or 
arrowroot until the bowels are regulated again, and when 
that is done it may be advisable to return to the oatmeal 
or cracked wheat. The exercise of a little judgment and 
close observation in feeding a child will contribute greatly to 
its wellbeing; any diarrhoea or disturbance of the digestion 
must at once receive prompt attention and this can often be 
accomplished by change of food; to allow these disorders to 
run for any length of time is to invite serious consequences. 

Adults or grown persons have also their share of stomach 
troubles; as a rule they eat too much, too fast and do not 
masticate their food sufficiently. It is not so much what a 
person eats, but how he eats, not so much quality as quan- 
tity. 

After an exclusive dietary of milk dyspeptics should 
gradually return to a mixed diet, that is a regular dinner 
once a day; but eat slowly and masticate thoroughly; thus 
one eats rarely if ever too much. When the food is bolted, 
it makes little or no impression on the nerves of taste, nor 
does it appease the sense of hunger, and the only indication 
of satiety is a feeling of fullness. 

As to the time of taking one's dinner that depends alto- 
gether on the occupation and habits of the individual. In 
dyspeptics in whom the digestion is slow and the circulation 
sluggish the principal meal or dinner should be eaten at noon ; 
this gives opportunity to move about, stimulating the circula- 
tion, hence increasing the absorption to its highest point. If 
a man eats his dinner in the evening and afterwards goes out 






412 HOME TREATMENT. 

into society or attends amusements the late dinner is not 
objectionable. But if a person is worn and tired out at sup- 
per and then eats a hearty meal, and lounges around the 
room the remainder of the evening, reading the newspaper 
or otherwise inactive, he is quite likely to feel distress from 
what he ate, and sure to experience occasional bilious spells; 
nightmare disturbs his sleep and he awakes in the morning 
unrefreshed, languid and dull. It is better for such persons 
to eat their dinner at noon, and retire early on a very light 
supper. 

Beef tea became very popular at one time as a nourish- 
ment for the sick, and there can be no doubt that many pa- 
tients who were stricken down with different acute diseases 
slipped into their graves, because beef tea was relied upon 
with a belief that it was a sufficient nourishment. Observa- 
tion and careful researches on the subject have proved con- 
clusively that the nutritive value of beef tea as ordinarily 
prepared, that is chopped beef put into a bottle and boiled 
in a water bath for three or four hours, has been greatly ex- 
aggerated. The process of boiling the beef has no other ef- 
fect than that of drawing out the watery substance of the 
meat. The phosphatic salts that are contained in the meat 
are also extracted with the serum which holds them in so- 
lution. The natural albuminoids (musculine) which con- 
stitute the real nutritive element of beef are congealed and 
surrounded by the fibrous tissue — that part which snarls 
up and renders the beef gristly and tough. Yet as a nutri- 
tive stimulant, beef tea possesses at times considerable value; 
it is an excellent vehicle sometimes, for instance an egg 
thoroughly beaten and added to a cupful of warm beef tea 
is a desirable form of liquid food for invalids. 

Eggs constitute a highly nitrogenized food and their 
nutritive value is even greater than that of stall-fed beef. 
The subjoined tables of chemical analysis give the definite 
quantity of each constituent that is contained in one hun- 
dred parts of egg and beef: 



SOMETHING ABOUT DIET. Il.» 

Stall-fed Beef. Ego. Lean Beef, 

Phosphatic salt 0.5 1.0 1.5 

Albuminoids 10.5 15.0 17.5 

Fat 45.0 12.0 6.0 

Water 44.0 72.0 75.0 

100.0 100.0 100.0 

If we compare the analysis of egg with that of milk, a 
remarkable similarity will be observed, save one exception, 
namely the carbo-hydrate sugar of milk is lacking in egg, 
and in order that eggs have the same property of nourishing 
the body as milk, this element may be readily supplied by 
eating a little bread. The writer is familiar with the history 
of a case in which a patient was kept on an exclusively egg 
diet for five months, and during this time he increased his 
weight thirty-eight pounds ; he consumed eight eggs and 
twelve ounces of bread a day. 

We hear considerable unfavorable comment in regard to 
hard-boiled eggs, and indeed for good and sufficient reason, 
but the indigestibility of the hard-boiled egg is not due to 
any change in the nature of the albumen because it is boiled; 
the cause is entirely mechanical. The reason is that a hard- 
boiled egg is not sufficiently divided by the ordinary proc- 
ess of mastication to allow the gastric juice to attack it from 
all sides; if it were finely pulverized either by the teeth or 
otherwise it would be as readily digested as a soft-boiled or 
raw egg. 

A raw fresh egg that is thoroughly beaten with an egg 
beater is the most readily digested food that there is. The 
author has known dyspeptics who could not digest any other 
kind, and by adding a pinch of salt and half to one table- 
spoonful of whisky after it is thoroughly beaten, it is cer- 
tainly one of the most valuable foods for a certain class of 
stomach troubles that can be recommended. Patients whose 
digestion is very weak should begin with one egg every four 
hours until four eggs are taken during the. day; when the 
strength increases, two may be taken for breakfast, and one 
for each meal the rest of the day; after the lapse of a few 



414 HOME TREATMENT. 

days another may be added to the second meal, and so the 
number gradually increased until eight are consumed; pru- 
dence would not go beyond this number lest an excess of 
nitrogenous matter overtax the liver and kidneys to elimi- 
nate it from the system and this result in other complica- 
tions. 

Dyspeptics, more than others, must avoid overtaxing 
the digestive organs, and while the stomach is sensitive 
and for a long time afterwards, they must avoid solid food. 

The quantity of bread must also be jealously guarded; 
while the stomach is very sensitive and weak it had better 
be entirely suspended and when resumed no more than 
three ounces should be eaten at each meal to begin with. For 
those dyspeptics whose stomachs possess average digestive 
power, and who require a nourishing and readily digestible 
meal, the writer would recommend for breakfast a milk 
gruel to which a raw egg has been added: he directs that 
four tablespoonfuls of oatmeal mush be mixed with three- 
quarters of a pint of warm milk and this worked through a 
tin strainer by means of a potato masher ; to the milk gruel 
so obtained and again moderately warmed, a raw fresh egg 
is added, which has been previously beaten to a foam, and 
then the whole mess is again beaten together, seasoned with 
salt and served in a bowl. 

Medicines should play a very minor part in the treatment 
of dyspepsia; the artificial pepsin preparations are all over- 
rated and their supposed efficacy is due to a careful and 
regulated diet rather than to the virtue of the pepsin. If 
the bowels are costive and if the stomach is sour and feels 
oppressed, prescription No. n will materially relieve these 
symptoms. 

A person who is suffering from indigestion must above 
all things learn to discipline himself; when that has been 
once accomplished the task of carrying out an appropriate 
diet will become an easy one, and restoration to health and 
strength will be the reward. 



INDEX 



ABORTION. The practice on the 

-£*- increase, and not due to a single 

cause, 113, 114, 115, 116. 

is it ever justifiable? 111. 

meaning of the term, 110. 

criminal, 101. 

Catholic Church is decisive on, 
112. 
Abrupt termination of pregnancy con- 
stitutes a disease, 117. 
Abscess in peritonitis, 278. 

iu perimetritis, 278. 

of the breast, 340. 
Abuses of surgery, 19. 
"A bad getting up," 204. 
A husband should not cease to be a 

gentleman, 94. 
A little reflection, 250. 
Academicians' view of fetal life, 102. 
Acton, Dr. "A warning against 

sexual dangers," 92. 
After the delivery, 334. 
Amenorrhcea, 132, 133. 
Anatomy of the female organs, 119. 
Anteflexion of the womb, 242. 
Anteversion of the womb, 240. 
Antidotes to poisons, 3S9, 390, 391. 
Antiseptic precautions, 75. 
Apostoli, Georges, Dr., 298, 301. 
Arnold, Prof., on cancer, 218. 



B 



ABY, barbarous practice of bath- 
ing, 337. 
care of the, 337. 



Baby, first toilet of the, 338. 
Bacteria, 286. 
"Bad getting up," 144. 
Bandaging after delivery, 250. 
Bartholow, Prof., 296. 
Battery, 294, 295. 
Beef tea, 412. 
Bennet, John H. , 400. 
Bennett, Dr., 196, 197. 
Berkeley, Bishop, 47. 
Bladder, catarrh of, 163. 

catarrh, and other diseases, 157. 

chronic catarrh of, 164. 

hemorrhage of, 16S. 

inflammation of, 158, 159. 

in pregnancy, 308. 

irritability of, 252. 

nervous irritability of, 166. 

paralysis of, 167. 

ulceration of, 163. 
Braid, Dr. (discoverer of hypnotism), 

54. 
Brain, fat an essential food for the, 

400. 
Braine, Dr. Woodhouse, 51. 
Breast, or mamma?, of the pregnant 
woman. 318. 

abscess of, 340. 
Bright's disease, 397. 
Broken bones, 378. 
Bronchitis, 350. 
Brown-Sequard, 394. 
Burns and scalds, 382. 

classification of, 383. 

useful application for, 3S5. 
415 






416 INDEX. 



/CAMPBELL, DR. HENRY F., 

^ 254. 

Cancer, Prof. Arnold on diagnosis of, 

218. 
Carbolic acid, poisoning from, 389. 
Carbonic-acid poisoning in chlorosis, 

135. 
Carpenter, Prof. W. B., 48. 
Castration, 274. 
Catarrh of the womb, 219. 
cause of, 213. 
symptoms of, 215. 
vaginal and uterine, 177. 
Catarrhal inflammation of the womb, 
209. 
of the mouth, 342. 
Cellulitis, pelvic, 285. 
in childbed, 288. 
Cervical endometritis, 211. 
Charcot, Dr. Experiments in hypno- 
tism, 54. 
on "Impersonal Sleep," 54. 
Chicken-pox, 375. 
Childbed fever, my first case, 74. 
Children are common objects of love, 
96. 
will of, 53. 
diseases of, 356. 
Chlorosis, iron in, 137. 
Chronic inflammation of the womb, 104. 

causes of, 105. 
Clothing to avoid taking cold, 190. 
Coated tongue, 341. 
Cohnheim, Prof., his theory of inflam- 
mation, 147. 
Coition and conception widely differ- 
ent processes, 106. 
Coitus, injury of interruption or in- 
complete, 96. 
Cold, injurious effects of taking, 184, 

185. 
Colic of infants, 360. 
Conception, independent of the sexual 

act, 107. 
Conjugal onanism, Dr. Devay, 96. 



Constipation, 366. 

causes of, 366. 

in pregnancy, 319, 320. 

treatment of, 367. 
Continence, 95. 
Convulsions in children, 361. 
Corset waist, 191. 
Cow, exercise of, 401. 
Cows' milk, 403. 

cream of, 403. 

density of, 403. 
Croup, 348. 

false, 349. 

membranous, 349. 
Cutler, Dr. Ephraim, 298. 
Cystitis, acute, 161. 

chronic, 162. 



D ALTON, PROF., on menstru- 
ation, 130. 
Dame Nature, 41. 
Danger of overheating, 189. 
Darwinian theory applicable to the 

overcrowded professions, 17. 
Days of doctrines and rules, 17. 
Delusions as to the curative value of 

drugs, 36. 
Depraved associates pave the way to 

feticide, 114. 
Descartes, 48. 
Diarrhoea, 357. 

prescription for, 357. 
in pregnancy, 320. 
Diet, 392. 

morbid fancy for, 392. 
for pregnant women, 324. 
Digestion, 396. 

of fats and starches, 399. 
Diphtheria, 346. 
Disease is as much a vital process as 

health, 37. 
Diseases of children, 341. 

that are conjured up in the minds 
of susceptible persons, 25. 



INDEX. 



41 



Disinfection of the lying-in woman ii 

Germany, 289. 
Dispersing electrode, 299. 
Divided skirts, 194. 
Dobell, Dr. Horace, 1S9. 
Drowning, 3S7. 

treatment for, 3S8. 
Drug diseases of Hahnemann, 43. 
Drugs are physical agents, 44. 
Ditvelius, Dr., 212. 
Dysmenorrhea, 13S. 

prescription for, 142. 

inflexion, 244. 
Dyspepsia, or indigestion, 137, 138. 
Dyspeptics, 411, 414. 



EGGS, 412, 413. 
Elastic garters, 193. 
Electricity in diseases of women, 
297. 
as a remedy, 294. 
in catarrhal inflammation, 302. 
in subinvolution, 303. 
medical, 296. 
without puncture, 200. 
Electrodes and poles, 295. 
Electro-punctm-e, 29S. 
Emergency treatment in sudden acci- 
dents, 377. 
Endometritis, 209. 

acute and chronic. 210. 
Engelman, Dr., 299. 
English law on " cpiickening," 104. 
Epileptic fits cured by a " Christian 

Scientist," 57. 
Equestrian tights, 195. 
Erosions often mistaken for cancer, 

218. 
Eruptive fevers, 370. 
Evans, Dr., 47. 
Exclusiveness that has characterized 

the professions, 16. 
Exercise, must be interesting, 63. 
in the open air, 62. 



Expectation or attention influences 
the bodily functions, 50. 



h 



JIAITH cures disease, 55. 



Falling of the womb, or pro- 
lapsus, 231. 
Fallopian tubes, 124. 
Fats, digestion of, 399. 
Feeding, intervals between, 395. 
Ferguson, Dr., 400. 
Feticide, 101. 
Fire, clothing on, 384. 
Flexion of the uterus, 139. 
Flexions and versions due to abor- 
tions, 117. 
Floor of the pelvis, 228. 
Flux, 358. 
Fly-blister, causing inflammation of 

the urethra, 152. 
Food, repugnance to, 393. 

liquid for invalids, 393. 
Fractures, 378. 

Fright causes and cures disease, 58. 
Frost-bite, 385. 

treatment for, 387. 
Functional diseases, 56. 



/GALVANOMETER, 300. 

**■* General causes of uterine and 
pelvic diseases, 61. 

Germ theory of disease, 77. 

German measles, 372. 

Germans, river-bathing of, 77. 

Germicidal properties of drugs, 176. 

Girls should be independent to choose 
their choice, 66. 

Gonorrhceal infection, statistics of, 
276. 

Goodells, Prof., on " abuses of uter- 
ine treatment," 22. 
on uterine symptoms, 140. 

Graafian follicles, 263. 

Green sickness, 133, 134. 



418 



INDEX. 



Growth of the uterus from the mo- 
ment of conception, 72. 



HEMORRHAGE of the womb, 
143, 144. 
of wounds, 381. 
arrest of, 382. 
Hemorrhoids, causing inflammation of 
urethra, 152, 322. 
in irritability of bladder, 166. 
Heroic treatment, 42. 
Hippocrates's view of fetal life, 102. 
Histology of inflammation, 145. 
How a woman should lie after con- 
finement, 335. 
Human ovum, size of, 264. 
Hygiene of gynecology, 78, 79. 
Hygienic measures, 182, 183. 
Hypnotism, 52. 
Hysteria, amenable to mind cure, 56. 



ICE-BAGS, 291. 
Imagination is the realm of the 
soul, 49. 
Impersonal sleep of Dr. Charcot, 54. 
Improprieties of dress, 68, 69, 70. 
Imprudence during menstruation, 

71. 
In the realm of thought there is no 

monopoly, 15. 
Indigestion, 356. 
Infants fed on cows' milk, 406. 

overfeeding of, 394. 
Infection, 287. 

gonorrhoea!, 81. 
innocent, 81. 
Inflammation, 145. 
of the womb, 196. 
chronic, 203. 
Interpolar regions, 297. 
Intra-abdominal pressure, 233. 
Involution, 73. 
Iron pills in chlorosis, 137. 



T7" NEE-CHEST posture, 254. 

J-^- in relaxed vagina, ISO. 
in falling of the womb, 236. 



LAITY, object of educating the, 18. 
Landois, Prof., on the curative 
force in the lower animals, 
39. 
Laws on abortion, 104, 105. 
Leucorrhcea, 80, 176. 
Little girls, muco-purulent secretion 

of the vagina, 152. 
Lochial discharge, 84. 
Lung fever, 352. 

Lying on the back after confinement, 
73. 



MALTHUS, law of, 99. 
Man, instinctive desire of, 89. 
Mania for cutting operations, 21. 
Marital excesses, and prevention of 

conception, 87. 
Marital excesses the mainspring of 

disease, 91. 
Married women exposed to infectious 

contamination, 80. 
Martin, Dr., of Chicago, 300. 
Massey, Dr. G. Batton, 297. 
Measles, 370, 371. 
Measurements of the healthy uterus, 

71. 
Mechanical age, 19. 
Menopause and puberty, 129. 
Menorrhagia and metrorrhagia, 143, 

144. 
Menstrual disorders, 131. 
Menstruation and menstrual disor- 
ders, 126. 
^Menstruation, average period of, 

128. 
precocious, 132. 
source from which the blood 

comes, 128. 



ini) i ■: x . 



419 



Menstruation suspended during preg- 
nancy, 129. 
Menstruation, climate and tempera- 
ment, 127. 
Menstruation, diversity in ages, 

12G. 
Mental photography in the hypnotic 

state, 54. 
Mesmerism, 52. 
Metritis, 190. 

acute, 19S. 

causes of, 199. 

chronic, 203. 

cold applications in, 201. 

treatment for, 200, 207, 20S. 
Metrorrhagia, 143. 
Milk, 400. 

analysis of, 408. 

arrowroot with, 410. 

boiled, 404. 

condensed, 410. 

gruel for, 410. 

diarrhceal diseases from, 406. 

from the country, 402. 

promiscuously mixed, 402. 

quantity to be taken, 4C5. 

sterilizing the, 406. 

shake, 404. 
Milk-leg, 290. 
Mill, John Stuart, 99. 
Milliampere, 300. 
Moral restraint, 90. 
More thought required to make 
good mothers than to file 
briefs or write prescriptions, 
68. 
Morning-sickness, 300. 
Morphine habit vice asthma, 60. 
Mouth, catarrh of the, 342. 

putrid sore, 342. 
Mucous membrane, 182. 
Mumps, 344. 
Murchison, Dr., 397. 
Mystic union of the soul with the 
body, 102. 



NAVEL, care of the, 338, 339. 
Nerve .strain, 140, 141, 152. 

Nervous and congestive dysmenor- 
rhea, 140. 

Nervous system in chlorosis, 135. 

Nervousness, due to excessive men- 
tal application, 63. 

Negative pole, 301. 

Nine years of my professional life, 15. 

Noeggerath, Dr., on gonorrhoeal in- 
fection, 276. 



OBJECT of educating the laity, 18. 
Ovaries, 124. 
acute inflammation, 266, 267. 
chronic inflammation, 270. 
cysts or tumors of, 264. 
diseases of, 263. 
displacement of, 266. 
incomplete or rudimentary, 266. 
supernumerary, 265. 
Ova, number discharged at the men- 
strual period, 131. 
Ovaritis, 266, 267. 

treatment of, 269, 272. 



PAIN in the abdominal walls, 321. 
Painful sensations from imagi- 
nary causes, 48. 
Painless childbirth, 325. 
Palpitation of the heart, 321. 
Parametritis, 2S5. 
Parotitis, 344. 
Pelvis, true, 120. 

false, 119. 

floor of the, 228. 
Perimetritis and peritonitis, 275. 
Perineum, 121. 
Period of fruitfulness, 264. 
Peritonitis and perimetritis, 275. 
Peritonitis, treatment of, 282, 283. 

criminal abortion the cause, 281. 
Piles, 322. 



420 



INDEX. 



Playfair, Dr., 401. 
Pneumonia, 352. 

treatment for, 354. 
Poisons, 388, 389, 390, .391. 
Precocious talents should not be 

forced, 64. 
Pregnancy, breasts become enlarged 
in, 308. 
bladder trouble in, 321. 
constipation in, 319, 320. 
capricious appetite in, 307. 
deposit of coloring matter, 

308. 
duration of, 305. 
diet in, 324. 
extra-uterine, 305. 
false, 306. 

menstruation during, 306. 
nausea and vomiting, 319. 
salivation of the mouth, 307, 

319. 
simulating, 314. 
symptoms of, 305, 306. 
unnatural, 305. 
Pregnant woman, precautions to, 
316. 
clean linen for the, 318. 
proper clothing for, 315. 
Preliminary signs of labor, 330. 
Preparation of homcepathic dilutions, 

44. 
Prolapsus, or falling of the womb, 

231. 
Protophytes, 286. 
Psychical exaggeration, 140. 
Ptomaines are developed from un- 

cleanliness, 83. 
Puberty and menopause, 129. 
Puerperal or childbed fever, 77, 78, 

290. 
Pulsation of the fetal heart, 

311. 
Putrefactive germs, 286. 
Putrid or septic poison, 287. 
Pyosalpinx, 285. 



QUICKENING, 103, 104, 310. 
Quinsy, 344. 



REPARATIVE energy of nature, 
38. 
Reparative process after confinement, 

233. 
Retroflexion in pregnancy, 256. 

treatment of, 252. 
Retroflexion of the womb, 247. 
Retroflexion, replacement of, 254, 

255. 
Retroversion of the womb, 246. 
Round ligaments of the womb, 248. 
Rose-rash, 372. 
Rumbold, Dr. Thos. F., 184. 



SALPINGITIS, 259. 
treatment for, 260, 261. 

Sawyer, Dr. Herbert C, 58. 

Scalds, 382. 

Scarlet fever, 373, 374, 375. 

Schelling, William Joseph, 47. 

Scrofulous diseases, 400. 

Serous membrane, 277, 278. 

Sexual desire, Prof. Carpenter on, 89, 
90. 

Sexual instinct not unholy and de- 
praved, 109. 

Signs and symptoms of pregnancy, 
305. 

Signs of chronic inflammation of the 
womb, 207. 

Skin, or integument, 182. 

Somnambulism, 52. 

Soor, 343. 

Sore nipples, 339. 

Soxhlet, Prof., 406. 

Spasms in children, 361. 

Spermatozoa, 89, 100. 

measurements of, 105. 

Spruce, 343. 

Stages of labor, 332. 



INDEX. 



421 



.Sterility in flexion, 244. 

in ovaritis, 272. 

due to abortion, 118. 
Sterilization of milk, 407. 
Stoics' view of fetal life, 102. 
Stricture of the neck of the womb, 

139. 
Stupidity of the masses, 23. 
Subinvolution of the womb, 73. 
Sugar, digestion of, 398. 
Superfluous garments, 70. 
Sympathy will cause disease, 58. 
Syringe, proper selection of a, 181. 



TEMPERATURE for living-rooms, 
189. 
Terror causes or cures disease, 58. 
The bed for confinement, 329, 330. 
The choice of a physician, 32S. 
The care of the baby, 337. 
The nurse, 328. 

The righting of the organ, 331. 
Thermae, 70. 
Thrush, 341. 
Tonsilitis, 344. 

Too much mischievous doctoring, 24. 
Tubal dropsy, 259. 
Tuke, Dr. Daniel H., 50. 
Tying the cord, 336. 



UNCLEANLINESS a cause of 
disease, 76. 
Union suits, 194. 
Urethra, 121. 

gonorrhoeal infection of, 152. 
in pregnancy, 155. 
in the newly married, 156. 
inflammation of, 150. 
irritation of, 150. 
neuralgia of, 155. 
Urethritis and neuralgia of the ure- 
thra, 150. 
caused by eruptive fevers, 152. 



Urethritis in pregnancy, 153. 

papillated growths ami mucous 
polypoids, 153. 
Urinary fistula, 170, 171. 
Uterus, 123. 

anteflexion, 242. 

anteversion, 240. 

changes after confinement, 72. 

measurements after confinement, 

72. 
natural position and support, 226, 

227. 
prolapsus, or falling of the, 

236. 
retroflexion, 247. 
retroversion, 246. 
treatment for prolapsus, 236. 
versions and flexions, 240. 



VAGINA, 122. 
catarrh of, 175. 
catarrh in children, 177, 178. 
acute and chronic inflammation 

of the, 172. 
gonorrheal infection of, 174. 
knee-chest posture in catarrh of 

the, 180. 
relaxed, mistaken for falling of 
the womb, 179, 180. 
Vaginal douches after confinement, 

335. 
Vaginal injections, directions for their 

use, 85, 86. 
Versions and flexions due to abortions, 

117. 
Virchow, Prof., theory of inflamma- 
tion, 146. 



"VXT ARMING a dwelling, 186. 

* " Weapon ointment, 41. 
What is mind-cure ? 46. 
What is termed mind-cure is not mind- 
cure, 40. 



422 



INDEX. 



When the soul becomes associated 
with the body, 107. 

When to begin to train mothers, 65. 

Whey, 409. 

While in childbed, 328. 

Whites, 176. 

Whom to teach, 15. 

Whooping-cough, 367, 368, 369. 

Why crowd our girls into the profes- 
sion? 67. 

Winter cough, 1S9. 

Wives who become delicate and ner- 
vous, 93. 

Womb, 123. 

tear or laceration of, 84. 



Women's rights vice women's wrongs, 

68. 
Women, after getting up from con- 
finement, 74. 
Worms, 363, 364, 365. 
Wounds, 378. 

contused, 379. 

incised, 379. 

lacerated, 379. 

poisoned, 3S0, 381. 

punctured, 379. 



^IEGLER, Prof., on infection, 286. 



OCT -0 !9'i 



